经云。疠者。营气热 。其气不清。故使鼻柱坏而色败。皮肤疡溃。风寒客于脉而不去。名
曰疠风。风气与太阳俱入。行诸脉俞。散于分肉之间。与卫相干。其道不利。故使肌肉 而有
疡。卫气有所碍而不行。故其肉有不仁也。病骨节重。须眉落。名曰大风。脉风成为疠。疠风者。
数刺其肿上已。刺以锐针针其处。按出其恶气。肿尽乃止。常食方食。毋食他食。观内经之论。
当分营卫为治。古方虽多。但混泻其风热于营卫。又无先后之分。至东垣丹溪始分之。活法机要
云。先桦皮散。从少至多。服五七日。灸承浆穴七壮。灸疮愈再灸。三灸之后。服再造散。祛血
分之风热。戒房室三年病愈。此先治其卫。后治其营也。丹溪云。疠风须分在上在下。看其疙瘩。
先见在上体多者。气受之也。以醉仙散取臭毒恶血于齿缝中也。先见在下体多者。血受之也。以
再造散取恶物虫积于谷道中出。所以虽有上下道路
之异。然皆不外于阳明一经而已。若上下同得者。气血俱受也。用必胜散上下兼取。阳明主胃与
大肠。无物不受故也。夫气为阳为卫。血为阴为营。身半以上阳先受之。身半以下阴先受之。故
再造散治其病在阴者。用皂角刺出风毒于营血中。肝主血。恶血留止。其属肝也。虫亦生于厥阴
风木所化。必用是法治其脏气。杀虫为主。以赤槟榔出营分毒邪。白牵牛出卫分毒邪。大黄引入
肠胃。利出瘀血恶物。醉仙散治病在阳者。用鼠粘子出风毒遍身恶疮。亚麻逐风。滋肺润皮肤。
蒺藜主恶血身体风痒。通鼻气。防风为诸风之引导。栝蒌根治瘀血。消热 肿。枸杞和血。消风
热。散疮毒。蔓荆子主贼风。苦参治热毒风。皮肤肌肉烦躁生疮。赤癞眉脱。八味药治功固至。
然必银粉为使。银粉乃下膈通大肠之要剂。用以驱诸药入阳明经。开其风热怫郁。逐出恶风臭秽
之毒。杀所生之虫。循经上行。至牙齿软薄之分。而出其臭毒之涎水。服此药。若有伤于齿。则
以黄连末揩之。丹溪取二方。为破敌之先锋。必胜散。则兼二方之妙用。但须慎口味戒房室。服
之必效。治疠风五法。一出汗。用麻黄、荆、防、羌、独、皂、角、苦参、全蝎之类。热服覆汗。
二熏浴。先用黄柏、黄连、薄荷为末。水调涂眼四围。次用荆芥、苦参、风藤、枳壳、苍耳、羌
活、桑槐桃柳枝、连根葱。煎汤熏浴。浴起。用木通、石菖蒲、大黄为末。加麝少许。擦患上。
三敷擦。用白矾、川槿皮、五倍子、全蝎为末。加斑螫少许。香油调敷。野狼油尤妙。燥痒用大枫
肉、番木鳖、乌柏仁、黑芝麻、黑豆、杏仁、木棉子。共捣一处。入炀成罐内。以铁盏盖上。铁
线扎定。铁钉旋紧。糠火中煨一夜。取其药油调后药。预用胡椒、川椒各二两。枯矾、轻粉各六
钱。为细末。入前药油。调匀擦患处。数日如蛇蜕脱下。再擦二次效。肥人用川乌、草乌、细辛、
杏仁、白附子、雄黄、白芥子为末。加麝少许。生姜蘸擦。顽浓者。加斑螫、白砒。不时擦之。
擦时须觅空房。用纸糊好。勿见风。七日后。又换别静房居之。以前房便溺臭秽不堪
也。七日后。日擦一次。至病痊为度。如有一处不知痛痒。即是病根。如前但擦其处。日三五次。
四汤液。用凉膈、双解、消风散之类。五丸散。用九龙丸、漆黄丸、 丸、白花蛇丸、鹅翎散、
蜈蚣散选用。疠风诸药不效。千金耆婆万病丸。极有神验。疠风面目蠕动。升麻胃风汤。并用桃
柳槐桑枝煎汤熏洗。面肿。服消风、凉膈之类。外用硫黄、雄黄、乳香、没药、血竭、轻粉、枯
矾、麝香、乌贼骨为散。香油调敷肿处。七日不得洗面。效。疠风脚底穿。用番木鳖酥炙三钱。
苎麻一斤。烧灰存性为散。空心酒下一钱。重者。不过一月效。如过服恶寒作呕者。胡椒汤服之
即止。疠风眉毛脱落。用鹿角锉炒存性六钱。皂角 灰存性一两。姜蘸擦眉上。日三五次。又方。
用骨碎补去毛炙干。生半夏为末等分。生姜蘸擦。日五七次。内服一味皂角刺。炒脆为末。食后
白酒酿或茶清服二钱。白瘢风者。血虚不能濡润经络。毒邪伤犯肺经气分也。圣惠方用桑枝十斤。
茺蔚草穗三斤。煎膏温酒调服。外用雄黄、硫黄、黄丹、南星、枯矾、密陀僧等分。姜蘸擦之。
擦后渐黑。再擦则愈。一方。无黄丹、南星。用白茄子。切去一头蘸擦。紫云风。气滞不能统运
血脉。毒邪蕴结肝经血分也。服用 叶一斤。漆叶半斤。俱蜜润九制。丸如弹子大。白汤调服。
又方。用苦参、何首乌、大胡麻、白蒺藜、菖蒲、赤茎 、薄荷、漆叶煎服。外用硫黄、官粉。
鸡子清调搽。鹅掌风。用核桃壳、鸽粪。煎汤频洗效。又方。用生桐油涂指上。以蕲艾烧烟熏之。
七日不可下水效。疠疡砭刺一法。子和谓一汗抵千针。盖以砭血不如发汗之周遍也。然夺汗者无
血。夺血者无汗。二者一律。若恶血凝滞肌表经络者。宜刺宜汗。汗用一味浮萍。曝干为末。每
服三钱。以黑豆淋酒。食远临卧调服。温覆取汗。禁食动风发毒之物。强者。连日服之。元气稍
弱者。须服一日。间二三日。与地黄丸间服。以病退七八为度。疠风初起。麻木不仁。用万灵丹
汗之。以散凝滞风毒。此与豆淋酒下浮萍之意不殊
也。恶血蕴结于脏。非荡涤其内则不能瘥。若毒在外者。非砭刺遍身患处及两臂腰尻。两手足指
缝及委中。各出血。其毒必不能散。若表里俱受毒者。非外砭内泄。其毒决不能退。如有寒热头
疼等证。当须大补气血。服轻粉之剂。若腹痛去后。兼有脓秽之物。不可用药止之。若口舌肿痛。
秽水时流作渴。发热喜冷。此为上焦热毒。泻黄散。若寒热往来。小柴胡加知母。若口缝出血。
发热而大便秘结。此为热毒内淫。黄连解毒汤加犀角、连翘。若大便调和。犀角地黄汤。若疠风
气。下焦脚弱。或腠理开汗大泄者。越婢加术汤。若秽水虽尽。口舌不愈。或发热大渴而不能饮
冷。此为虚热也。七味白术散。
丹方。治疠风赤肿。属血病者。以鲮鲤甲。随患先起处。取甲涂生漆于里面。砂内炙脆为末。
清晨陈酒调服七八分。三服效。七日愈。随处取甲治之。
薛立斋曰。疠风多由劳伤气血。腠理不密。或醉后房劳沐浴。或登山涉水。外邪所乘卫。气
相搏。湿热相并。血随火化而致。眉毛先落者。毒在肺。面发紫泡者。毒在肝。脚底先痛或穿者。
毒在肾。遍身如癣者。毒在脾。目先损者。毒在心。此五脏受病之重者也。一曰皮死麻木不仁。
二曰肉死针刺不痛。三曰血死烂溃。四曰筋死指脱。五曰骨死鼻柱坏。此五脏受伤不可治也。大
抵风自头面起者为顺。自足心起者为逆。若声哑目盲。尤为难治。治当辨本证兼证变证类证。阴
阳虚实而斟酌焉。若妄投燥热之剂。脓水淋漓。而肝血愈燥。风热愈炽。肾水愈枯。相火愈旺。
反为坏证矣。口 目斜。若手足牵搐。或眉棱痒动。或面发紫泡。或成块。属肝经血虚风热。用
加味逍遥散、六味地黄丸以生肝血。滋肾水。若寒热往来。或耳聋胁痛。属肝木炽盛。用柴胡四
物汤以清肝火。生肝血。若筋挛骨痛。不能动履。用六味丸、补
中益气以滋化源。身上虚痒。此血不营于腠理。所以痒也。四物加酒芩煎服。调紫背浮萍末。痒
甚。加荆芥、蝉蜕。夏秋湿热行令。若饮食不甘。头目眩晕。遍体酸软。而两腿麻木。口干自汗。
气促身热。小便黄数。大便稀溏。湿热伤元气也。清燥汤。身起疙瘩。搔破脓水淋漓。若寒热往
来者。肝经气血虚而有火也。加味逍遥散。若肌腠搔如帛隔者。气血不能外营也。人参养胃汤。
若面部搔之麻痒者。气血不能上营也。补中益气汤。口舌生疮。或咽喉作痛。或饮食喜冷。大便
秘结者。实热也。四顺清凉饮。肌热恶热。烦渴引饮者。血虚也。当归补血汤。牙齿作痛。或牙
龈溃烂。若喜寒恶热。属胃火。清胃散为主。舌赤裂。作渴引饮。或小便频数。不时发热。或热
无定处。或足心热起者。乃肾水干枯。心火亢盛。用加减八味丸。若误用寒凉。必变虚寒而死。
〔诊〕脉两寸浮而紧。浮而洪。阳脉浮弦。阴脉实大。浮缓者易治。洪大而数。或沉实者难愈。
脉沉而病在上。脉浮而病在下。及无汗者。皆为不治之证也。
《内经》中说：疠病，是营气发热，其气不纯净，所以导致鼻梁塌陷、面色败坏，皮肤发生溃疡。风寒邪气侵袭经脉而不去除，称为疠风。风气与太阳经之气一同进入，运行于各脉的俞穴，散布在分肉之间，与卫气相互干扰，导致经络通道不畅，所以使肌肉产生溃疡。卫气受到阻碍而不能正常运行，所以肌肉出现麻木不仁的症状。如果病情发展到骨节沉重、眉毛胡须脱落，称为大风。脉象见风邪即为疠风。治疗疠风，应当多次针刺肿胀部位以消除肿胀；用锐针针刺患处，按压排出恶浊之气，直到肿胀完全消退才停止。平时只吃常规的食物，不要吃其他食物。观察《内经》的论述，治疗时应当区分营分和卫分进行调理。古代方剂虽然很多，但大多混杂地泻除营卫中的风热，又没有先后次序之分。到了李东垣和朱丹溪才开始加以区分。《活法机要》记载：先服用桦皮散，从少量逐渐增加到最大量，连续服用五到七天，然后灸承浆穴七壮，等灸疮愈合后再灸，三次灸治之后，服用再造散，以祛除血分中的风热，并戒绝房事三年，病即可痊愈。这是先治卫分，后治营分的治法。
朱丹溪说：治疗疠风必须区分病位在上或在下。观察身上的疙瘩，如果先出现在上半身较多，说明气分受邪，可以用醉仙散，通过齿缝引出臭毒恶血；如果先出现在下半身较多，说明血分受邪，可以用再造散，通过肛门（谷道）引出恶物虫积。虽然有上下途径的不同，但都不外乎阳明一经的影响。如果上下同时患病，说明气血都受到了侵害，使用必胜散上下兼取。因为阳明经主管胃和大肠，没有什么东西是不接受的。气属于阳，即卫；血属于阴，即营。身体上半部阳气先受邪，身体下半部阴气先受邪。所以再造散治疗病在阴分的，用皂角刺将风毒从营血中引出。肝主血，恶血留滞，属于肝经病变。虫也是由厥阴风木所化生的，必须用这种方法调理脏气，以杀虫为主。用赤槟榔排出营分的毒邪，白牵牛排出卫分的毒邪，大黄引导药力进入肠胃，利出瘀血恶物。醉仙散治疗病在阳分的，用鼠粘子（牛蒡子）将风毒从遍身恶疮中引出，亚麻祛风，滋润肺脏和皮肤，蒺藜主治恶血引起的身体风痒，通鼻气，防风作为诸风的引经药，栝楼根治疗瘀血，消除热肿，枸杞调和血液，消除风热，消散疮毒，蔓荆子主治贼风，苦参治疗热毒风，缓解皮肤肌肉烦躁生疮、赤癞眉脱等症状。这八味药的功效确实很好，但必须以银粉为使药。银粉是下膈通大肠的重要药物，用来驱使诸药进入阳明经，开通风热的郁结，驱逐出恶风臭秽的毒素，杀死滋生的虫子。药力循经上行，到达牙齿软薄的部位，从而排出臭毒的涎水。服用此药，如果损伤了牙齿，就用黄连末擦拭。朱丹溪选取这两个方子，作为破敌的先锋。必胜散则兼具两个方子的妙用，但必须注意忌口和戒绝房事，服用必定有效。
治疗疠风有五种方法：
一是发汗法。使用麻黄、荆芥、防风、羌活、独活、皂角、苦参、全蝎等药物。热服后覆盖衣被取汗。
二是熏浴法。先用黄柏、黄连、薄荷研成粉末，用水调匀涂抹眼睛四周。然后用荆芥、苦参、风藤、枳壳、苍耳、羌活、桑枝、槐枝、桃枝、柳枝、带根的葱，煎汤熏洗。洗浴结束后，用木通、石菖蒲、大黄研成粉末，加入少许麝香，擦涂患处。
三是敷擦法。用白矾、川槿皮、五倍子、全蝎研成粉末，加入少许斑蝥，用香油调匀敷贴。野狼油尤其好。如果是燥痒，用大枫子、番木鳖、乌桕仁、黑芝麻、黑豆、杏仁、木棉子，共同捣碎一处，放入烧红的罐内，用铁盏盖住，用铁丝扎紧，铁钉旋紧，在糠火中煨烤一夜，取其药油来调和后面的药物。预先准备胡椒、川椒各二两，枯矾、轻粉各六钱，研成细末，加入前面的药油，调匀擦涂患处。几天后如蛇蜕皮一样脱落，再擦两次即见效。肥胖的人用川乌、草乌、细辛、杏仁、白附子、雄黄、白芥子研成粉末，加入少许麝香，用生姜蘸着擦涂。脓液顽固厚重的，加入斑蝥、白砒，不时擦涂。擦涂时必须寻找空房间，用纸糊好，不要见风。七日后，又换到另一个安静的房间居住，因为前一个房间的大小便气味臭秽不堪。七日后，每天擦涂一次，直到病愈为止。如果有一处不知道痛痒，那就是病根，像前面那样只擦涂那个部位，每天三到五次。
四是汤液法。使用凉膈散、双解散、消风散之类的方剂。
五是丸散法。选用九龙丸、漆黄丸、[缺失药名]丸、白花蛇丸、鹅翎散、蜈蚣散等。如果疠风的各种药物都无效，可以使用千金耆婆万病丸，极有神效。疠风导致面目蠕动，使用升麻胃风汤，并用桃枝、柳枝、槐枝、桑枝煎汤熏洗。面部肿胀，服用消风散、凉膈散之类。外用硫黄、雄黄、乳香、没药、血竭、轻粉、枯矾、麝香、乌贼骨研成散剂，用香油调匀敷在肿胀处。七天不得洗脸，见效。疠风脚底穿孔，用番木鳖酥炙三钱，苎麻一斤，烧灰存性研成散剂，空腹用酒送服一钱。重症者，不超过一个月见效。如果因过服药物导致恶寒呕吐，用胡椒汤服用即可停止。疠风眉毛脱落，用鹿角锉碎炒至存性六钱，皂角灰存性一两，用生姜蘸着擦涂眉毛上，每天三到五次。另一方法，用骨碎补去毛炙干，生半夏研成粉末，两者等分，用生姜蘸着擦涂，每天五到七次。内服一味皂角刺，炒脆研成粉末，饭后用白酒酿或茶清送服二钱。
白瘢风，是血虚不能濡润经络，毒邪伤犯肺经气分所致。《圣惠方》用桑枝十斤，茺蔚草穗三斤，煎膏，温酒调服。外用雄黄、硫黄、黄丹、南星、枯矾、密陀僧等分，用生姜蘸着擦涂。擦涂后逐渐变黑，再擦涂则痊愈。另一方，不用黄丹、南星，用白茄子，切去一头蘸着擦涂。
紫云风，是气滞不能统运血脉，毒邪蕴结肝经血分所致。服用[缺失药名]叶一斤，漆叶半斤，都用蜜润九制，制成如弹子大的丸剂，白开水调服。另一方，用苦参、何首乌、大胡麻、白蒺藜、菖蒲、赤茎[缺失药名]、薄荷、漆叶煎服。外用硫黄、官粉，鸡蛋清调搽。
鹅掌风，用核桃壳、鸽粪，煎汤频繁清洗见效。另一方，用生桐油涂在手指上，用蕲艾燃烧烟熏之，七天不可沾水见效。
疠疡砭刺法，张子和认为一次发汗抵得上千次针刺，因为放血不如发汗那样周遍全身。然而夺汗者无血，夺血者无汗，这两者原理一致。如果有恶血凝滞在肌表经络，适宜针刺或发汗。发汗用一味浮萍，晒干研成粉末，每次服用三钱，用黑豆淋酒，在饭后临睡前调服，温覆取汗，禁食动风发毒之物。体质强者，连日服用。元气稍弱的，须服用一天，间隔两三天，与地黄丸交替服用，以病退七八分为度。疠风初起，麻木不仁，用万灵丹发汗，以散凝滞的风毒。这与用豆淋酒送服浮萍的意思相同。
恶血蕴结在脏腑，如果不荡涤内部就不能痊愈。如果毒邪在外部，如果不砭刺遍身患处及两臂、腰尻、两手足指缝及委中穴，各自出血，毒邪一定不能消散。如果表里都受毒邪，如果不外砭内泄，毒邪一定不能消退。如果有寒热头痛等症状，应当大补气血，服用轻粉制剂。如果腹痛腹泻后，兼有脓秽之物，不可用药止泻。如果口舌肿痛，秽水时常流出且口渴，发热喜冷，这是上焦热毒，用泻黄散。如果寒热往来，用小柴胡汤加知母。如果口缝出血，发热且大便秘结，这是热毒内淫，用黄连解毒汤加犀角、连翘。如果大便调和，用犀角地黄汤。如果疠风气滞，下焦脚弱，或者腠理开泄大汗淋漓，用越婢加术汤。如果秽水虽尽，口舌不愈，或者发热大渴但不能饮冷，这是虚热，用七味白术散。
丹方：治疗疠风赤肿，属于血病的，用鲮鲤甲（穿山甲），根据患部先起的地方，取甲涂生漆在内面，砂内炙脆研成粉末，清晨用陈酒调服七八分，三服见效，七日痊愈。随处取甲治疗均可。
薛立斋说：疠风多由劳伤气血，腠理不紧密，或者醉后房劳沐浴，或者登山涉水，外邪乘虚而入，卫气与之相搏，湿热相并，血随火化而导致。眉毛先落的，毒在肺；面部发紫泡的，毒在肝；脚底先痛或穿孔的，毒在肾；遍身如癣的，毒在脾；眼睛先受损的，毒在心。这是五脏受病的重症。一种叫皮死，麻木不仁；二叫肉死，针刺不痛；三叫血死，烂溃；四叫筋死，手指脱落；五叫骨死，鼻梁塌陷。这是五脏受伤不可治愈的情况。大抵风从头部面部起的为顺证，从足心起的为逆证。如果声音嘶哑、眼睛失明，尤为难治。治疗应当辨别本证、兼证、变证、类证，根据阴阳虚实来斟酌处理。如果妄投燥热之剂，会导致脓水淋漓，肝血更加干燥，风热更加炽盛，肾水更加枯竭，相火更加旺盛，反而成为坏证。口眼歪斜，如果手足抽搐，或者眉棱骨痒动，或者面部发紫泡，或者成块，属于肝经血虚风热，用加味逍遥散、六味地黄丸以生肝血，滋肾水。如果寒热往来，或者耳聋胁痛，属于肝木炽盛，用柴胡四物汤以清肝火，生肝血。如果筋挛骨痛，不能活动行走，用六味丸、补中益气汤以滋养化源。身上虚痒，这是因为血不能营养腠理，所以发痒。用四物汤加酒芩煎服，调入紫背浮萍末。痒得厉害，加荆芥、蝉蜕。夏秋湿热盛行时，如果饮食不甘，头目眩晕，遍体酸软，而两腿麻木，口干自汗，气促身热，小便黄数，大便稀溏，这是湿热伤了元气，用清燥汤。身上起疙瘩，搔破后脓水淋漓，如果有寒热往来，是肝经气血虚而有火，用加味逍遥散。如果肌肤搔抓感如帛隔，是气血不能外营，用人参养胃汤。如果面部搔抓时麻痒，是气血不能上营，用补中益气汤。口舌生疮，或者咽喉作痛，或者饮食喜冷，大便秘结，是实热，用四顺清凉饮。肌热恶热，烦渴引饮，是血虚，用当归补血汤。牙齿作痛，或者牙龈溃烂，如果喜寒恶热，属于胃火，以清胃散为主。舌红裂，作渴引饮，或者小便频数，不时发热，或者热无定处，或者足心热起，乃肾水干枯，心火亢盛，用加减八味丸。如果误用寒凉，必变为虚寒而死。
【诊法】脉象两寸浮而紧，浮而洪，阳脉浮弦，阴脉实大，浮缓者易治。洪大而数，或者沉实者难愈。脉沉而病在上，脉浮而病在下，以及无汗的，都是不治之证。
The *Neijing* (Inner Canon) states: Leprosy (*Li*) is characterized by heat in the Ying (Nutrient) Qi, causing its nature to be impure. Consequently, it leads to the collapse of the nasal bridge and a deteriorated complexion, with ulcers and sores on the skin. When Wind-Cold pathogens invade the meridians and remain, it is called Leprous Wind (*Li Feng*). The pathogenic wind enters together with the Taiyang (Greater Yang) channel, circulates through the Shu (Transport) points of various meridians, and scatters between the muscle layers, interfering with the Wei (Defensive) Qi. This obstruction hinders the smooth flow of pathways, resulting in ulcers in the muscles. Since the Wei Qi is hindered and cannot circulate freely, numbness and insensitivity occur in the flesh. If the condition progresses to heavy joints and loss of eyebrows and beard, it is called Great Wind (*Da Feng*). A pulse indicating wind signifies leprosy. To treat leprosy, one should repeatedly puncture the swollen areas to reduce swelling; use a sharp needle to prick the affected site, press to expel foul qi, and stop only when the swelling completely subsides. One should consume only regular food and avoid other foods. Observing the discussions in the *Neijing*, treatment should distinguish between the Ying (Nutrient) and Wei (Defensive) levels for regulation. Although ancient formulas are numerous, they often indiscriminately drain wind-heat from both Ying and Wei without distinguishing sequence. It was not until Li Dongyuan and Zhu Danxi that a distinction was made. *Huofa Jiyao* records: First, administer Huapi San (Birch Bark Powder), starting from a small dose and gradually increasing to the maximum, taken continuously for five to seven days. Then moxa the Chengjiang (CV24) acupoint with seven moxibustion cones. After the moxibustion wound heals, moxa again. After three rounds of moxibustion, administer Zaizao San (Reconstruction Powder) to dispel wind-heat from the Blood level, and abstain from sexual intercourse for three years for recovery. This is a method of treating the Wei level first, then the Ying level.
Zhu Danxi stated: Treating leprosy requires distinguishing whether the pathology is upper or lower. Observe the nodules on the body; if they appear predominantly on the upper half, the Qi level is affected. Use Zuixian San (Intoxicating Immortal Powder) to extract foul blood through the gum margins. If they appear predominantly on the lower half, the Blood level is affected. Use Zaizao San to extract foul matter and parasites via the anus. Although the routes differ, all pertain to the Yangming (Yang Brightness) channel. If both upper and lower parts are affected simultaneously, both Qi and Blood are involved. Use Bisheng San (Invincible Powder) to treat both upper and lower. This is because the Yangming channel governs the Stomach and Large Intestine, accepting everything. Qi belongs to Yang, which is Wei; Blood belongs to Yin, which is Ying. The upper half of the body is affected by Yang pathogens first, and the lower half by Yin pathogens first. Therefore, Zaizao San treats pathology in the Yin level by using Gaojiao Ci (Gleditsia Spine) to draw out wind-toxin from the Ying-Blood. The Liver governs Blood; stasis of foul blood indicates Liver involvement. Parasites are also generated from the Jueyin (Terminal Yin) Wind-Wood transformation. Thus, this method must be used to regulate the Zang organs, focusing on killing parasites. Chi Binglang (Areca Seed) expels toxin from the Ying level; Bai Qianniu (Morning Glory Seed) expels toxin from the Wei level; Dahuang (Rhubarb Root) guides the medicine into the intestines and stomach to promote the discharge of stasis and foul matter. Zuixian San treats pathology in the Yang level by using Niuzi (Burdock Fruit) to draw out wind-toxin from widespread sores; Yama (Flaxseed) dispels wind and moistens the Lungs and skin; Jili (Tribulus Fruit) treats foul blood-induced pruritus and opens the nasal passages; Fangfeng (Saposhnikovia Root) acts as a guide for various winds; Gualougen (Trichosanthes Root) treats blood stasis and reduces heat-swelling; Gouqi (Goji Berry) harmonizes blood, dispels wind-heat, and dissipates sores; Manjingzi (Vitality Fruit) treats thief-wind; Kushen (Sophora Root) treats heat-toxic wind, relieving restlessness, sores, red leprosy, and eyebrow loss. These eight herbs are indeed effective, but Yin Fen (Calomel) must be used as an assistant drug. Yin Fen is a crucial agent for descending through the diaphragm and unblocking the Large Intestine, used to drive other medicines into the Yangming channel, open the stagnation of wind-heat, expel foul wind and odorous toxins, and kill parasites. The medicinal power ascends along the meridian to the soft teeth, expelling foul saliva. If this medication damages the teeth, wipe them with Huanglian (Coptis Rhizome) powder. Zhu Danxi selected these two formulas as vanguard troops. Bisheng San combines their efficacies but requires strict dietary control and abstinence from sex; it will surely be effective.
There are five methods for treating leprosy:
1. Sweating Method: Use Ephedrae Herba (Mahuang), Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), Notopterygii Rhizoma et Radix (Qianghuo), Saussureae Radix (Duhuo), Gleditsiae Fructus (Zaogao), Sophorae Flavescentis Radix (Kushen), and Scorpio (Quanxie). Take hot and cover to induce sweating.
2. Fumigation and Bathing Method: First, mix Phellodendri Cortex (Huangbai), Coptidis Rhizoma (Huanglian), and Menthae Haplocalycis Herba (Bohe) into powder, apply with water around the eyes. Then decoct Schizonepetae Spica (Jingjie), Sophorae Flavescentis Radix (Kushen), Pteridis Massae (Fengteng), Aurantii Fructus (Zhike), Xanthii Fructus (Cangerzi), Notopterygii Rhizoma et Radix (Qianghuo), branches of Morus alba (Sangzhi), Sophora japonica (Huai zhi), Persicae Semen (Tao zhi), Salix matsudana (Liuzhi), and green onions with roots. Fumigate and bathe. After bathing, apply powder of Akebiae Caulis (Mutong), Acori Tatarinowii Rhizoma (Shichangpu), and Rhei Radix et Rhizoma (Dahuang) with a little Moschus (Shexiang) to the affected area.
3. Application and Rubbing Method: Use Alum (Baifan), Hibiscus mutabilis root bark (Chuanjinpi), Myrobalan (Wubeizi), and Scorpio (Quanxie) as powder, add a little Mylabris (Banzhe), and mix with sesame oil for application. Wolf fat is excellent. For dry itching, use Semend Acanthopanacis Senticosi (Dafengzi), Strychni Semen (Fanmubie), Paviae Semen (Wubairen), Sesami Nigris Semen (Heizhima), Sojae Semen Nigrum (Heidou), Armeniacae Semen Amarum (Xingren), and Gossypii Semen (Mumianzi). Crush together, place in a heated jar, cover with an iron lid, secure with iron wire and nails, and simmer in chaff fire overnight. Extract the medicinal oil to mix with subsequent drugs. Prepare Piperis Longi Fructus (Hujiao) and Zanthoxyli Pericarpium (Chuanjiao), 2 liang each; Calcined Alum (Kufan) and Calomel (Qingfen), 6 qian each. Grind to fine powder, mix with the aforementioned oil, and rub on the lesion. After several days, the skin may shed like snake skin; rub twice more for effect. For obese patients, use Aconiti Lateralis Radix Praeparata (Chuanwu), Aconiti Kusnezoffii Radix (Caowu), Asari Radix (Xixin), Armeniacae Semen Amarum (Xingren), Typhonii Rhizoma (Baifuizi), Realgar (Xionghuang), and Sinapis Albae Semen (Baijiezi) as powder, add a little Moschus (Shexiang), and rub with fresh ginger. For stubborn pus, add Mylabris (Banzhe) and Orpiment (Baipi). Rub occasionally. Find an empty room, seal with paper, avoid wind. After seven days, move to another quiet room due to foul odor. After seven days, rub once daily until cured. If any area lacks sensation, it is the root cause; rub that area specifically, 3-5 times daily.
4. Decoction Method: Use Liangge San (Cool the Chest Powder), Shuangjie San (Double Resolution Powder), Xiaofeng San (Dispel Wind Powder), etc.
5. Pill and Powder Method: Select Jiulong Wan (Nine Dragons Pill), Qihuang Wan (Lacquer Yellow Pill), [Missing Name] Wan, Bungarus Parvus Pill (Baihuashe Wan), Eling San (Goose Feather Powder), or Wugong San (Centipede Powder). If all leprosy medicines fail, use Qianjin Qipo Wanbings Wan (Thousand Gold Qibo All-Disease Pill), which is extremely effective. For facial twitching in leprosy, use Shengma Weifeng Tang (Ephedra and Stomach Wind Decoction), fumigating and washing with peach, willow, sophora, and mulberry branch decoctions. For facial swelling, take Xiaofeng San or Liangge San. Externally, apply powder of Sulphur (Huangshan), Realgar (Xionghuang), Boswelliae Resina (Ruxiang), Myrrhae Resina (Moyao), Draconis Sanguis (Xuexie), Calomel (Qingfen), Calcined Alum (Kufan), Moschus (Shexiang), and Sepiae Endoconcha (Wuzeigu) mixed with sesame oil to the swollen area. Do not wash the face for seven days for effect. For perforated soles in leprosy, use Strychni Semen (Fanmubie) prepared with butter, 3 qian, and Boehmeriae Niveae Fibre (Zhuma) 1 jin, burned to ash. Take 1 qian with wine on an empty stomach. Severe cases resolve within a month. If excessive medication causes aversion to cold and vomiting, stop with Piper Longum (Hujiao) decoction. For eyebrow loss in leprosy, use Cervi Cornu Colla (Lu jiao) processed to ash, 6 qian, and Gleditsiae Fructus (Zaogao) ash, 1 liang. Rub with ginger on eyebrows, 3-5 times daily. Another method: use Drynariae Rhizoma (Gusuibu) dried and Pinelliae Rhizoma (Banxia) raw, equal parts, rubbed with ginger, 5-7 times daily. Internally, take roasted Gleditsiae Spine (Zaogao ci) powder, 2 qian, after meals with rice wine or tea infusion.
Vitiligo (*Baiban Feng*) is caused by Blood deficiency failing to moisten meridians and toxic pathogens injuring the Qi level of the Lung channel. *Shenghui Fang* uses Mulberry Branch (Sangzhi) 10 jin and Leonuri Fructus (Chongweicao) 3 jin, decocted into paste, taken with warm wine. Externally, apply Realgar (Xionghuang), Sulphur (Huangshan), Minium (Huandan), Arisaema Cum Bile (Nanxing), Calcined Alum (Kufan), and Litharge (Mituoseng) equally, rubbed with ginger. It turns black upon rubbing, then heals. Another formula uses white eggplant cut at one end for rubbing.
Purple Cloud Wind (*Ziyun Feng*) is caused by Qi stagnation failing to govern blood circulation and toxic pathogens accumulating in the Blood level of the Liver channel. Take [Missing Name] leaf 1 jin and Lacquer Tree Leaf (Qiyè) 0.5 jin, honey-processed nine times, made into pills the size of marbles, taken with plain water. Another formula: decoct Kushen (Sophora Root), He Shou Wu (Polygonum Multiflorum), Da Hu Ma (Sesamum Indicum), Bai Ji Li (Tribulus), Shi Chang Pu (Acorus), Chi Jing [Missing], Bohe (Mint), and Qi Ye (Lacquer Leaf). Externally, apply Sulphur (Huangshan) and Official Powder (Guanfen) mixed with egg white.
Goose Palm Wind (*Ezhang Feng*): Wash frequently with decoction of Walnut Shell (Hetao Qiao) and Pigeon Droppings (Ge Fen). Another method: Apply raw Tung Oil (Tongyou) to fingers and fumigate with Qiai (Artemisia argyi) smoke. Avoid water for seven days for effect.
Leprous Ulcer Bleeding/Cupping Method: Zhang Zihe said one sweating session equals a thousand needles, as bleeding is less comprehensive than sweating. However, "those who lose sweat have no blood; those who lose blood have no sweat." They are consistent principles. If foul blood stagnates in the skin and meridians, puncture or sweating is suitable. For sweating, use only Marrubium Vulgare (Fuping), dried and powdered, 3 qian per dose, taken with black bean steeped wine before bed, covered to sweat. Avoid wind-aggravating and toxin-releasing foods. Strong constitutions take it daily; weak constitutions take it one day, skip two-three days, alternating with Dihuang Wan (Rehmannia Pill), stopping when symptoms improve by 70-80%. Early leprosy with numbness uses Wanling Dan (Ten Thousand Spirit Pill) to sweat and disperse stagnant wind-toxin, similar to using Doulin Jiu (Bean-Infused Wine) with Fuping.
If foul blood accumulates in the Zang organs, internal purging is necessary for cure. If toxins are external, puncturing lesions on the body, arms, waist, buttocks, finger webs, and Weizhong (BL40) to bleed is required to disperse toxins. If both exterior and interior are affected, external cupping/puncturing and internal purging are needed to reduce toxins. If accompanied by chills, fever, headache, strongly tonify Qi and Blood and take Calomel (Qingfen) preparations. If abdominal pain follows with pus/feces, do not stop diarrhea with medication. If mouth/tongue swell, foul water flows, thirst, fever, preference for cold, this is Upper Jiao Heat-Toxin; use Xiehuang San (Drain Yellow Powder). If alternating chills and fever, use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Zhimu (Anemarrhena Rhizome). If mouth fissures bleed, fever, constipation, this is internal Heat-Toxin invasion; use Huanglian Jiedu Tang (Coptis Detoxification Decoction) plus Xijiao (Rhinoceros Horn - substitute with Water Buffalo Horn) and Lianqiao (Forsythia). If stool is normal, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). If leprosy Qi causes lower Jiao leg weakness or profuse sweating due to open pores, use Yebip Jia Zhu Tang (Yebip Plus Atractylodes Decoction). If foul fluids cease but mouth/tongue persist, or fever/thirst prevents drinking cold, this is Deficiency Heat; use Qiwei Baizhu San (Six-Atractylodes Macrocephala Powder).
Prescription: For red swelling in leprosy due to Blood pathology, use Pangolin Scale (Linglijia). Apply raw lacquer to the inner side of the scale according to the onset site, bake in sand until crisp, powder, and take 7-8 fen with aged wine in the morning. Effective in three doses, cured in seven days. Use scales found locally.
Xue Lizhai stated: Leprosy mostly results from labor damaging Qi and Blood, loose pores, or sexual activity/bathing after drunkenness, or climbing mountains/wading through water, allowing external pathogens to attack. Wei Qi struggles against pathogens, damp-heat merges, and Blood transforms with Fire. Eyebrow loss indicates toxin in Lung; purple blisters on face indicate toxin in Liver; painful/perforated soles indicate toxin in Kidney; body-wide eczema-like rash indicates toxin in Spleen; eye damage indicates toxin in Heart. These are severe Zang organ diseases. Five types of death: 1. Skin death (numbness); 2. Flesh death (no pain on puncture); 3. Blood death (ulceration); 4. Tendon death (finger loss); 5. Bone death (nasal collapse). These are incurable Zang injuries. Generally, wind starting from head/face is favorable; from soles is unfavorable. Hoarseness and blindness are very difficult to treat. Treatment must distinguish primary, concurrent, altered, and similar syndromes, adjusting for Yin/Yang and Deficiency/Excess. Misusing drying-hot agents causes dripping pus, dries Liver Blood, intensifies wind-heat, depletes Kidney Water, and excites Ministerial Fire, leading to bad outcomes. Facial paralysis, limb spasms, brow itching, purple blisters, or lumps indicate Liver Blood deficiency with Wind-Heat; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to generate Liver Blood and nourish Kidney Water. Alternating chills/fever, deafness, hypochondriac pain indicate Liver Wood excess; use Chaihu Siwu Tang (Bupleurum Four Substances Decoction) to clear Liver Fire and generate Liver Blood. Tendon cramps, bone pain, immobility indicate need for Liuwei Wan and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish the source. Body itch due to Blood failing to nourish pores: Siwu Tang plus Jiu Qin (Wine-fried Scutellaria), mixed with Zibei Fuping (Purple-backed Floating Fern) powder. Severe itch adds Jingjie (Schizonepeta) and Chantui (Cicada Slough). In summer/autumn damp-heat, if poor appetite, dizziness, body soreness, leg numbness, dry mouth, spontaneous sweating, shortness of breath, fever, yellow frequent urine, loose stools, this is damp-heat damaging Yuan Qi; use Qingzao Tang (Clear Dryness Decoction). Body nodules, bursting with pus, alternating chills/fever indicate Liver Qi/Blood deficiency with Fire; use Jiawei Xiaoyao San. Itching feeling like fabric rubbing indicates Qi/Blood failing to nourish exterior; use Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). Face itching/numbness indicates Qi/Blood failing to nourish upper; use Buzhong Yiqi Tang. Mouth/tongue sores, sore throat, preference for cold, constipation indicate Excess Heat; use Sishun Qingliang Yin (Four-Obedient Cooling Drink). Muscle heat, aversion to heat, thirst, desire to drink indicates Blood deficiency; use Danggui Buxue Tang (Angelica Tonifying Blood Decoction). Toothache, gum ulceration, preference for cold/aversion to heat indicates Stomach Fire; use Qingwei San (Clear Stomach Powder). Red cracked tongue, thirst, frequent urination, irregular fever, hot soles indicate Kidney Water dryness and Heart Fire excess; use Jiajian Bawei Wan (Modified Eight-Ingredient Pill). Misusing cold-cool agents leads to deficiency-cold death.
[Pulse Diagnosis] Pulses at both Cun positions floating and tight, or floating and surging; Yang pulses floating and wiry, Yin pulses solid and large; floating and slow are easy to treat. Surging-large-rapid or deep-solid are difficult to cure. Deep pulse with upper disease, floating pulse with lower disease, and absence of sweating are signs of incurability.