经曰∶诸痒为虚。血不荣肌腠，所以痒也。当以滋补药，以养阴血，血和肌润，痒自不作矣。（《丹溪》）
痒证不一。疥痨作痒，当求之本门疮疥证。血虚皮肤痒者，宜四物汤，加防风七钱半；如以四物
汤半帖，水二盏，调消风散一钱亦可。妇人血气，或通身痒，或头面痒，如虫行皮中，缘月水来时，为
风所吹，不然则是产蓐中食动风物致之，亦宜如前四物汤调消风散。有脾虚身痒，本无疥痨，
素非产蓐，洁然一身，痒不可住，此乃脾虚所因。经云∶诸痛为实，诸痒为虚。又云∶脾主身之肌肉。宜
实脾为先，四兽饮去草果，加藿香、浓朴、川芎、当归各半钱，姜、枣煎服，名增损资胃饮。（《要诀》）（
消风散见《头痛》，四兽饮见《疟》。）
一人年逾六十，形瘦苍紫，夜常身痒，搔之热蒸皮内，肉磊如豆粒，痒止热散，磊亦消矣。医用
乌药顺气、升麻和气等不效，诣余诊之。脉皆细濡近驶。曰∶此血虚血热也。
医为顺气和气，所谓诛罚无过，治非所宜。遂以生地、玄参、
白蒺藜、归、芎、 、芍、黄芩、甘草、陈皮煎服，月余而安。（《石山》）
程贵英，形长而瘦，色白而脆，年三十余，得奇疾，遍身淫淫循行如虫，或从左脚腿起，渐次而上至头，
复下于右脚，自觉虫行有声之状。召医诊视，多不识其为何病。居士往诊，其脉浮小而濡，按之不足，兼察其
形，视其色，参诸脉，知其为虚症矣。《伤寒论》云∶身如虫行，汗多亡阳也。遂仿此例而用补中益气汤，多
加参、 ，以酒炒黄柏五分佐之，服至二、三十帖遂愈。（《石山居士传》）
盛架阁妻，左右肩病痒，蔓延至两臂，上及颜面，不可禁。或于病处灼艾，势暂止，已而如初。府君曰∶右
脉沉，左脉浮且盛，此滋味伤浓之所致也。投以某药，疾旋已。（《医史·倪府君墓碣铭》）
《黄帝内经》说：各种瘙痒都是由于虚证引起的。血液不能滋养肌肉和皮肤纹理，所以会产生瘙痒。应当使用滋补药物，来养护阴血，血液调和、肌肤滋润，瘙痒自然就会停止。（出自朱丹溪）
瘙痒的证候有多种不同。由疥疮或痨病引起的瘙痒，应当在治疗疮疥的章节中寻求根本原因。因血虚导致皮肤瘙痒的，适宜使用四物汤（补血调经的基础方），加入七钱半防风；如果用半帖四物汤，加水两盏，调入一钱消风散（祛风止痒的方剂）也可以。妇女因气血失调，或者全身瘙痒，或者头面部瘙痒，感觉像虫子在皮肤里爬行，这是因为月经来潮时，被风邪侵袭所致；如果不是这种情况，那就是因为分娩坐月子期间食用了容易动风的食物导致的，也适宜按照前面所述的方法，用四物汤配合消风散服用。有脾虚导致的身体瘙痒，原本没有疥疮或痨病，平时也没有经历分娩产褥期，全身洁净，但瘙痒难忍，这是由于脾虚引起的。医经说：各种疼痛属于实证，各种瘙痒属于虚证。又说：脾主司身体的肌肉。因此应当以补益脾气为优先，使用四兽饮（温中健脾的方剂）去掉草果，加入藿香、厚朴、川芎、当归各半钱，加生姜、大枣煎服，名为增损资胃饮。（出自《济生拔粹要诀》）（注：消风散见《头痛》篇，四兽饮见《疟疾》篇。）
有一人年龄超过六十岁，形体消瘦，肤色苍紫，夜间经常身体瘙痒，搔抓后感觉热气从皮内蒸腾而出，皮下出现如豆粒大小的硬结，瘙痒停止后热气消散，硬结也随之消退。医生使用乌药顺气散、升麻和气汤等药物治疗无效，于是前来找我诊治。脉象都细弱濡软且接近快速。我说：这是血虚兼有血热。之前的医生使用顺气和气的药物，这叫做“诛罚无过”（对无邪之处进行攻伐），治疗并不适宜。于是我用地黄、玄参、白蒺藜、当归、川芎、白芍、黄芩、甘草、陈皮煎服，一个月左右病情安定。（出自《石山医案》）
程贵英，身材修长而瘦削，面色苍白而肤质脆弱，三十多岁，患了一种奇异的疾病，全身瘙痒，游走不定如同虫行，有时从左脚腿开始，逐渐向上蔓延至头部，再下行至右脚，自觉有虫子爬行发出声音的感觉。召集医生诊视，大多不认识这是什么病。居士（指作者或患者亲友中的懂医者）前去诊治，其脉象浮小且濡软，重按无力，同时观察其形体，查看其面色，参考脉象，知道这是虚证。《伤寒论》说：身体感觉像虫子爬行，是因为出汗过多导致阳气亡失。于是仿照这个例子使用补中益气汤（补中益气、升阳举陷的方剂），大量增加人参、黄芪，用酒炒过的黄柏五分作为佐使药，服用二三十帖后痊愈。（出自《石山居士传》）
盛架阁的妻子，左右肩部患病瘙痒，蔓延至双臂，向上波及颜面，难以忍受。有人在患处施灸，症状暂时停止，不久又恢复如初。府君（指倪维德）说：右脉沉，左脉浮且旺盛，这是饮食肥甘厚味损伤脾胃所致。投用某种药物后，疾病很快就好了。（出自《医史·倪府君墓碣铭》）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: All itching is due to deficiency. When blood fails to nourish the muscles and skin texture, itching occurs. One should use tonifying medicines to nourish Yin and blood; when the blood harmonizes and the skin becomes moist, the itching will cease naturally. (From Zhu Danxi)
There are various types of itching syndromes. Itching caused by scabies or tuberculous sores should be sought in the chapter on treating skin sores for its root cause. For skin itching due to blood deficiency, Siwu Tang (Four Substances Decoction) is suitable, with seven qian half of Fangfeng (Saposhnikovia Root) added; alternatively, half a dose of Siwu Tang can be taken with two cups of water, mixed with one qian of Xiaofeng San (Eliminate Wind Powder). In women, due to Qi and blood disorders, there may be whole-body itching or itching of the head and face, feeling like insects crawling under the skin. This is often because wind pathogens invaded during menstruation; if not, it may be caused by consuming foods that stir up wind during the postpartum confinement period. In such cases, it is also appropriate to use Siwu Tang combined with Xiaofeng San as described above. There is body itching due to Spleen deficiency, where there are no scabies or tuberculous sores, and no history of childbirth or confinement. The body is clean, yet the itching is unbearable. This is caused by Spleen deficiency. The medical classics state: All pain belongs to excess, all itching belongs to deficiency. It also says: The Spleen governs the muscles of the body. Therefore, strengthening the Spleen should be the priority. Use Six Beast Drink (Si Shou Yin) without Caoguo (Tsaoko Fruit), adding Huoxiang (Patchouli Herb), Houpo (Magnolia Bark), Chuanxiong (Ligusticum Rhizome), and Danggui (Angelica Sinensis Root), each half a qian, decocted with Shengjiang (Fresh Ginger) and Dazao (Jujube), named Zengsun Ziwei Yin (Modified Stomach-Nourishing Drink). (From *Jisheng Baci Yaojue*; note: Xiaofeng San is seen in the "Headache" section, Si Shou Yin in the "Malaria" section.)
A man over sixty years old, thin with a sallow-purple complexion, suffered from frequent night-time body itching. Scratching produced a sensation of heat steaming from within the skin, and nodules the size of bean grains appeared subcutaneously. When the itching ceased, the heat dissipated, and the nodules disappeared. Physicians used Wuyao Shunqi San (Atractylodis Rhizoma and Linderae Radix Powder) and Shengma Heqi Tang (Cimicifugae Rhizoma and Harmonizing Qi Decoction) without effect. He came to me for diagnosis. The pulse was fine, soggy, and rapid. I said: This is blood deficiency with blood heat. The previous physicians used methods to smooth and harmonize Qi, which constitutes "punishing the innocent" (attacking where there is no pathogen), and thus the treatment was inappropriate. I prescribed Dihuang (Rehmanniae Radix), Xuanshen (Scrophulariae Radix), Baijili (Tribuli Fructus), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Rhizome), Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix), and Chenpi (Citri Reticulatae Pericarpium), decocted and administered. After more than a month, he recovered. (From *Shishan Yi'an*)
Cheng Guiying, tall and thin, with a pale complexion and fragile constitution, in his thirties, suffered from a strange disease. His entire body itched, moving around like insects crawling. Sometimes it started from the left leg and gradually moved up to the head, then down to the right foot. He felt as if insects were crawling and making sounds. Physicians summoned could not identify the disease. A lay practitioner (or scholar-physician) examined him. The pulse was floating, small, and soggy, weak upon pressure. Observing his form and complexion and correlating with the pulse, he determined it was a deficiency syndrome. The *Shanghan Lun* (Treatise on Cold Damage) states: The body feeling like insects crawling is due to excessive sweating leading to Yang exhaustion. Following this example, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used, with significantly increased amounts of Renshen (Ginseng Radix) and Huangqi (Astragali Radix), assisted by five fen of Huangbai (Phellodendri Cortex) fried in wine. After taking twenty to thirty doses, he was cured. (From *Shishan Jushi Zhuan*)
The wife of Shang Jiage suffered from itching on both shoulders, spreading to both arms and up to the face, which was intolerable. Moxibustion applied to the affected areas temporarily stopped the symptoms, but they returned shortly after. Lord Ni (Ni Weide) stated: The right pulse is deep, while the left pulse is floating and vigorous. This is caused by damage from rich and greasy foods. After administering certain medicines, the illness quickly resolved. (From *Yishi: Epitaph of Lord Ni*)