〔薛〕腮属足阳明胃经,其生瘫者,多因儿食甘甜浓味,脾胃积热所致,亦有乳
母郁怒,儿受其患者。若因热积于内,二便不通者,用凉膈散。风邪相搏,二便
如常者,用漏芦汤。胃经风热,或兼咽喉肿痛,用升麻防风汤。若禀赋阴虚火动,
颏间或两耳内生疮,或出脓不止者,宜用地黄丸。若因乳母肝火乘脾,用加味逍
遥散。脾经郁热,用加味归脾汤。膏粱积热,用东垣清胃散。脾胃风热,用清咽
利膈汤。仍参口疮治之。
升麻防风汤 治胃经实热,咽痛,口燥,腮痈,等证。
升麻 防风 黄柏(炒) 茯苓 芍药(炒) 陈皮(各五分) 连翘 当归(各七分)
上,每服二钱,水煎,仍量大小用之。
清咽利膈汤 治心脾蕴热,或咽喉腮舌肿痛。
玄参 升麻 桔梗(炒) 甘草(炒) 茯苓 黄连(炒) 黄芩(炒) 牛蒡子(炒,杵)
防风 芍
药(炒。各等分)
上,每服一二钱,水煎。
《本事方》治小儿毒瓦斯攻腮,赤肿可畏者。
皂角(去核,二两) 天南星(生用,二钱) 糯米(一合)
上为细末。姜汁调涂,立效。
〔薛〕臂痈之证,当分经络所属,受证之因而治之。上廉属手阳明经,下廉属手
太阳经,外廉属手少阳经,内廉属手厥阴经,内之上廉属手太阴经,内之下廉属手
少阴经,或经络热郁,风邪外干,气血有乖,即生痈毒。若因心经有热者,导
赤散加黄连。心包络有热者,柴胡栀子散。肺经有热者,泻白散。大肠经有热者,
大连翘饮。 肿作痛者,气血凝结也,用仙方活命饮。肿痛不消者,欲作脓也,用
托里消毒散。脓熟不出者,气血虚也,用托里消毒散。脓出反痛者,气血虚甚也,肌
肉不生者脾胃气虚也,用五味异功散。不可外敷生肌散,恐反助其邪而肌肉难长也。
白芷升麻汤 治手阳明经分、臂上生疮。
白芷 升麻 桔梗(各一钱) 黄 (炒) 黄芩(酒炒。各二钱) 生黄芩(五分) 红花
甘草(炙。各五分)
上,水酒半钟煎,食后温服。
大连翘饮(即大连翘汤) 治肺热生疮。
连翘 HT 麦 荆芥 木通 赤芍药 当归 防风 柴胡 滑石 蝉壳 甘草(炒)
山栀子 黄芩(各等分)
上为末。每服二钱,加紫草,水煎服。大便不通,量加大黄。
【薛己】腮部属于足阳明胃经,发生痈肿的原因,多是因为小儿食用甘甜厚味的食物,导致脾胃积热所致;也有因乳母情绪郁怒,婴儿受其影响的。如果是因为热邪积聚在体内,导致大小便不通畅的,使用凉膈散。如果是风邪与内热相搏结,但大小便正常的,使用漏芦汤。如果是胃经风热,或者兼有咽喉肿痛症状的,使用升麻防风汤。如果是先天禀赋阴虚导致虚火妄动,下巴中间或两耳内部生疮,或者流脓不止的,适宜使用地黄丸。如果是因乳母的肝火侵犯脾土导致的,使用加味逍遥散。如果是脾经郁热,使用加味归脾汤。如果是饮食膏粱厚味积热,使用东垣清胃散。如果是脾胃风热,使用清咽利膈汤。治疗时仍要参考口疮的治疗方法。
升麻防风汤:治疗胃经实热,咽喉疼痛,口干舌燥,腮痈等症状。
处方组成:升麻、防风、黄柏(炒制)、茯苓、芍药(炒制)、陈皮(各五分),连翘、当归(各七分)。
用法:以上药物,每次服用二钱,加水煎煮,并根据患者年龄大小酌情调整用量。
清咽利膈汤:治疗心脾蕴藏热邪,或者咽喉、腮部、舌头肿痛。
处方组成:玄参、升麻、桔梗(炒制)、甘草(炒制)、茯苓、黄连(炒制)、黄芩(炒制)、牛蒡子(炒制并捣碎)、防风、芍药(炒制,各等分)。
用法:以上药物,每次服用一至二钱,加水煎煮。
《本事方》记载:治疗小儿毒瓦斯攻注腮部,红肿令人畏惧的症状。
处方组成:皂角(去核,二两)、天南星(生用,二钱)、糯米(一合)。
用法:以上药物研成细末。用姜汁调和后涂抹患处,立即见效。
【薛己】臂痈的证候,应当根据所属经络,分析致病原因进行治疗。上廉穴部位属于手阳明经,下廉穴部位属于手太阳经,外侧属于手少阳经,内侧属于手厥阴经,内侧上部属于手太阴经,内侧下部属于手少阴经。如果经络中热邪郁结,外感风邪侵袭,导致气血运行失常,就会发生痈毒。如果是因为心经有热,使用导赤散加黄连。心包络有热的,使用柴胡栀子散。肺经有热的,使用泻白散。大肠经有热的,使用大连翘饮。肿胀且疼痛的,是气血凝结所致,使用仙方活命饮。肿痛不消退的,是即将化脓的表现,使用托里消毒散。脓液成熟但不排出的,是气血虚弱所致,使用托里消毒散。脓液排出后反而疼痛的,是气血极度虚弱;肌肉不生长的,是脾胃气虚所致,使用五味异功散。不可外用生肌散,恐怕反而会助长邪气,导致肌肉难以生长。
白芷升麻汤:治疗手阳明经分部、手臂上生疮。
处方组成:白芷、升麻、桔梗(各一钱),黄芪(炒制)、黄芩(酒炒制,各二钱),生黄芩(五分),红花、甘草(炙制,各五分)。
用法:以上药物,用水和酒各半钟煎煮,饭后温服。
大连翘饮(即大连翘汤):治疗肺热生疮。
处方组成:连翘、薄荷、荆芥、木通、赤芍药、当归、防风、柴胡、滑石、蝉蜕、甘草(炒制)、山栀子、黄芩(各等分)。
用法:以上药物研成粉末。每次服用二钱,加入紫草,加水煎煮服用。如果大便不通畅,酌情加大黄。
[Xue Ji] The cheek belongs to the Foot-Yangming Stomach Meridian. The occurrence of carbuncles here is mostly caused by children consuming sweet and rich foods, leading to heat accumulation in the Spleen and Stomach; it can also result from a wet nurse's emotional depression and anger, which affects the infant. If heat accumulates internally causing obstruction of urination and defecation, use Liangge San (Cooling the Diaphragm Powder). If wind pathogen combats with internal heat but urination and defecation remain normal, use Loulu Tang (Radix Euphorbiae Humifusae Decoction). If there is wind-heat in the Stomach Meridian, or accompanied by sore throat and swelling, use Shengma Fangfeng Tang (Cimicifugae Rhizoma and Saposhnikoviae Radix Decoction). If constitutionally Yin-deficient with hyperactive fire, sores appear between the chin or inside both ears, or pus flows incessantly, Dihuang Wan (Rehmannia Pill) is suitable. If caused by Liver-fire invading the Spleen due to the wet nurse, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If there is stagnant heat in the Spleen Meridian, use Jiawei Guipi Tang (Modified Tonify the Spleen Decoction). If there is heat accumulation from rich diet, use Dongyuan Qingwei San (Dongyuan's Clear Stomach Powder). If there is wind-heat in the Spleen and Stomach, use Qingyan Lige Tang (Clear Throat and Cool Diaphragm Decoction). Treatment should still refer to the management of mouth ulcers.
Shengma Fangfeng Tang: Treats excess heat in the Stomach Meridian, sore throat, dry mouth, cheek carbuncle, etc.
Ingredients: Cimicifugae Rhizoma (Shengma), Saposhnikoviae Radix (Fangfeng), Phellodendri Cortex (Huangbai, stir-fried), Poria (Fuling), Paeoniae Radix (Shaoyao, stir-fried), Citri Reticulatae Pericarpium (Chenpi) (each 0.5 qian); Forsythiae Fructum (Lianqiao), Angelicae Sinensis Radix (Danggui) (each 0.7 qian).
Usage: Grind into powder. Take 2 qian per dose, decoct in water, adjusting dosage according to age.
Qingyan Lige Tang: Treats heat accumulation in Heart and Spleen, or swelling and pain in throat, cheeks, and tongue.
Ingredients: Scrophulariae Radix (Xuanshen), Cimicifugae Rhizoma (Shengma), Platycodonis Radix (Jiegeng, stir-fried), Glycyrrhizae Radix et Rhizoma (Gancao, stir-fried), Poria (Fuling), Coptidis Rhizoma (Huanglian, stir-fried), Scutellariae Radix (Huangqin, stir-fried), Arctii Fructum (Niubangzi, stir-fried and pounded), Saposhnikoviae Radix (Fangfeng), Paeoniae Radix (Shaoyao, stir-fried) (all equal parts).
Usage: Take 1-2 qian per dose, decoct in water.
*Ben Shi Fang* treats pediatric toxic heat attacking the cheeks, causing alarming redness and swelling.
Ingredients: Gleditsiae Fructus (Zaojiao, pitted, 2 liang), Pinelliae Tuber (Tian Nanxing, raw, 2 qian), Glacinis Semen (Nuomi, 1 he).
Usage: Grind into fine powder. Mix with ginger juice and apply topically for immediate effect.
[Xue Ji] For arm carbuncles, one must differentiate based on the affected meridian and treat according to the cause. The upper lateral aspect belongs to the Hand-Yangming Large Intestine Meridian, the lower lateral aspect to the Hand-Taiyang Small Intestine Meridian, the outer lateral aspect to the Hand-Shaoyang Sanjiao Meridian, the inner aspect to the Hand-Jueyin Pericardium Meridian, the upper inner aspect to the Hand-Taiyin Lung Meridian, and the lower inner aspect to the Hand-Shaoyin Heart Meridian. If heat stagnates in the meridians or wind pathogen invades externally, disrupting Qi and Blood circulation, carbuncles and toxins arise. If there is heat in the Heart Meridian, use Daochi San (Guide Out Red Powder) added with Coptidis Rhizoma (Huanglian). If there is heat in the Pericardium, use Chaihu Zhizi San (Bupleurum and Gardenia Powder). If there is heat in the Lung Meridian, use Xiebai San (Drain White Powder). If there is heat in the Large Intestine Meridian, use Da Lianqiao Yin (Large Forsythia Drink). If swelling and pain occur, indicating Qi and Blood coagulation, use Xianfang Huoming Yin (Immortal Life Preserving Drink). If swelling and pain persist, indicating suppuration, use Tuoli Xiaodu San (Support Interior and Eliminate Toxin Powder). If mature pus does not discharge, indicating Qi and Blood deficiency, use Tuoli Xiaodu San. If pain recurs after pus discharge, indicating severe Qi and Blood deficiency; if muscles fail to regenerate, indicating Spleen and Stomach Qi deficiency, use Wuyi Yigong San (Five Agents Supporting Merit Powder). Do not apply topical Shengji San (Generate Flesh Powder), as it may exacerbate pathogens and hinder muscle regeneration.
Baizhi Shengma Tang: Treats sores on the upper arm in the Hand-Yangming Meridian distribution.
Ingredients: Angelicae Dahuricae Radix (Baizhi), Cimicifugae Rhizoma (Shengma), Platycodonis Radix (Jiegeng) (each 1 qian); Astragali Radix (Huangqi, stir-fried), Scutellariae Radix (Huangqin, wine-fried) (each 2 qian), Raw Scutellariae Radix (Sheng Huangqin, 0.5 qian), Carthami Flos (Honghua), Glycyrrhizae Radix et Rhizoma (Gancao, honey-fried) (each 0.5 qian).
Usage: Decoct in half cup of water and wine, take warm after meals.
Da Lianqiao Yin (also known as Da Lianqiao Tang): Treats sores caused by Lung heat.
Ingredients: Forsythiae Fructum (Lianqiao), Menthae Haplocalycis Herba (Bohe), Schizonepetae Spica (Jingjie), Akebiae Caulis (Mutong), Paeoniae Radix Rubra (Chishaoyao), Angelicae Sinensis Radix (Danggui), Saposhnikoviae Radix (Fangfeng), Bupleuri Radix (Chaihu), Talcum (Huashi), Cryptotympanae Pergamen (Chanke), Glycyrrhizae Radix et Rhizoma (Gancao, stir-fried), Gardeniae Fructum (Shanzhizi), Scutellariae Radix (Huangqin) (all equal parts).
Usage: Grind into powder. Take 2 qian per dose, add Lithospermi Radix (Zicao), decoct in water and drink. If constipation occurs, adjust by adding Rheum Radix et Rhizoma (Dahuang).