(附∶斑、丹)
经曰∶风痹瘾疹,乃风气挟热,郁于腠理,无从发散。起于皮肤,不红不肿,惟有颗粒高起
而作痒者,风痹也;略有形迹见于皮肤者,瘾疹也。皆风热所成。或因新浴凑风及汗出脱解而得
;或挟暑湿,久而不退,亦变疮疡。如风热甚者,防风通圣散。脉多浮数。
主方 羌活 前胡(各一钱) 防风 天麻 蝉蜕 薄荷 川芎(各七分) 荆芥 连翘
栀子(各六分) 水煎服。
消风散 治诸风瘾疹(方见伤风)。未效,于风、火二门采方治之。
斑、丹火毒,皆热邪积久,郁于皮肤,轻为细斑,重为丹毒。如锦纹赤色,便秘心烦,风热
搏于荣血而成。自内出游四肢易治,四肢走入心腹难治。甚者排针刺出恶血,否则肌肉糜烂。
主方 防风 玄参 黄芩 栀子 生地黄 芍药 牛蒡子 连翘(各一钱) 枳壳 荆芥(
各七分),上水煎服。
防风通圣散 治丹毒(方见中风)。
白虎汤 丹毒渴甚(方见伤寒)。
简便方 寒水石 滑石 黄柏(等分) 青黛(减半) 芭蕉或冬青叶汁调敷。
又 大黄末、朴硝同研,水调敷。
又 赤小豆为末,鸡子清调。
又 慎火草(俗名火丹草)捣敷。
又 灶心土(一钱),淡豆豉末(五分),麻油调。
又 木鳖子煎油敷,最效(方见幼科火灼疮)。与外科丹毒参看。
(附注:斑、丹)
经典医籍记载:风痹和瘾疹,是由于风气挟带热邪,郁结在腠理(皮肤与肌肉之间的间隙),无法发散所致。病发于皮肤,如果不红不肿,仅有颗粒状高起并伴有瘙痒的,称为风痹;如果在皮肤上略有痕迹显现的,称为瘾疹。这两种病症都是由风热引起的。有的因为刚洗完澡就吹到风,或者出汗后脱衣受凉而得病;有的挟带暑湿之气,日久不退,也会转变为疮疡。如果风热症状严重的,使用防风通圣散治疗。脉象多表现为浮数。
主方:羌活、前胡(各一钱),防风、天麻、蝉蜕、薄荷、川芎(各七分),荆芥、连翘、栀子(各六分)。用水煎煮后服用。
消风散:治疗各种风邪引起的瘾疹(方剂详情见“伤风”章节)。如果无效,从治风和治火的方剂中选择进行治疗。
斑毒和丹毒的火毒,都是热邪积聚日久,郁结在皮肤所致。轻症表现为细小的斑点,重症则发展为丹毒。其色泽如锦缎上的红色纹路,伴有便秘和心烦,这是风热搏结于营血(运行于脉中的血液)而成。病邪从体内向外扩散至四肢容易治疗,若病邪从四肢向内侵入心腹则难以治疗。病情严重的,可用排针刺出恶血,否则会导致肌肉腐烂糜烂。
主方:防风、玄参、黄芩、栀子、生地黄、芍药、牛蒡子、连翘(各一钱),枳壳、荆芥(各七分)。以上药材用水煎煮后服用。
白虎汤:治疗丹毒且口渴严重的患者(方剂详情见“伤寒”章节)。
简便外敷方:寒水石、滑石、黄柏(等量),青黛(减半量)。用芭蕉汁或冬青叶汁调匀后敷贴患处。
又方:将赤小豆研成粉末,用鸡蛋清调匀敷贴。
又方:使用慎火草(俗称火丹草)捣烂后敷贴。
(Note: Macules and Erysipelas)
The classics state: Wind-bi (Wind-induced obstruction syndrome) and urticaria arise from wind qi carrying heat pathogen, stagnating in the couli (interstices between skin and muscle), with no way to dissipate. The pathology manifests on the skin; if there is no redness or swelling, but only granular elevations accompanied by itching, it is termed wind-bi; if slight traces appear on the skin, it is termed urticaria. Both are caused by wind-heat. They may result from exposure to wind immediately after bathing, or from undressing while sweating; they may also be complicated by summer-dampness, persisting for a long time without receding, eventually transforming into sores and ulcers. In cases of severe wind-heat, Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking the Intestines and Stomach) is indicated. The pulse is typically floating and rapid.
Main Formula: Qianghuo (Notopterygii Rhizoma et Radix) and Qianhu (Peucedani Radix), each 1 qian; Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), Chantui (Cicadae Periostracum), Bohe (Menthae Haplocalycis Herba), and Chuanxiong (Ligustici Chuanxiong Rhizoma), each 0.7 qian; Jingjie (Schizonepetae Spica), Lianqiao (Forsythiae Fructus), and Zhizi (Gardeniae Fructus), each 0.6 qian. Decoct in water and take orally.
Xiaofeng San (Wind-Dispersing Powder): Treats various types of wind-induced urticaria (see "Shangfeng" chapter for formula details). If ineffective, select formulas from the Wind and Fire categories for treatment.
The fire-toxin of macules and erysipelas results from heat pathogen accumulating over a long period and stagnating in the skin. Mild cases present as fine macules, while severe cases develop into erysipelas. The color resembles red patterns on brocade, accompanied by constipation and mental restlessness; this is formed by wind-heat clashing with ying-xue (nutritive blood). When the pathogen moves outward from the interior to the four limbs, it is easy to treat; when it moves inward from the limbs to the heart and abdomen, it is difficult to treat. In severe cases, pricking bloodletting with multiple needles should be performed to expel evil blood; otherwise, muscle tissue will rot and ulcerate.
Main Formula: Fangfeng (Saposhnikoviae Radix), Xuanshen (Scrophulariae Radix), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Shengdihuang (Rehmanniae Radix Recens), Shaoyao (Paeoniae Radix Alba), Niubangzi (Arctii Fructus), and Lianqiao (Forsythiae Fructus), each 1 qian; Zhiqiao (Aurantii Fructus) and Jingjie (Schizonepetae Spica), each 0.7 qian. Decoct the above ingredients in water and take orally.
Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking the Intestines and Stomach): Treats erysipelas (see "Zhongfeng" chapter for formula details).
Baihu Tang (White Tiger Decoction): Treats erysipelas with extreme thirst (see "Shanghan" chapter for formula details).
Simple External Application Formula: Hanshuishi (Calcitum), Huashi (Talcum), and Huangbai (Phellodendri Cortex) in equal parts; Qingdai (Indigo Naturalis) in half amount. Mix with juice of Bajiao (Musa basjoo) or Dongqingye (Ilex cornuta leaf) and apply externally.
Another Formula: Grind Dahuang (Rhei Radix et Rhizoma) powder and Puxiao (Natrii Sulfas) together, mix with water, and apply externally.
Another Formula: Grind Chixiaodou (Vigna umbellata) into powder, mix with egg white (Jiziqing), and apply externally.
Another Formula: Mash Shenhuocao (Chenopodium album, commonly known as Huodanc Cao) and apply externally.
Another Formula: Mix Zaoxintu (Calcinatum Cinnabarium? No, Caosuan Tan - Caulis Ziziphus Spinosae Ashed? Actually Zao Xin Tu is Fictor's Hearth Earth / Caudex Sinapis Albas Incineratus? Standard is Caosuan Tan or similar earth. Let's use Caulis Ziziphus Spinosae Ashed or simply Hearth Earth) (1 qian) and Danshidouchi (Sojae Semen Praeparatum) powder (0.5 qian), mix with Mazhong oil (Sesami Oleum) and apply.
Another Formula: Decoct Muguaizi (Momordicae Semen) to make an oil for external application; this is most effective (see "Youke Huozhuochuang" chapter for formula details). Refer to surgical treatments for erysipelas for comparison.