(附∶瘙痒)
经曰∶凡十二经络脉者,皮之部也。百病之生,必先于皮毛。邪中之则腠理开,开则入客于
络脉,留而不去,传入于经;留而不去,传入于腑, 于肠胃也。故皮者,有分部不与而生大病
也。又曰∶肺主皮毛,在脏为肺,在体为皮。故气不荣,则皮毛焦;津液去,则爪枯毛折而毙。
皮肤索泽,即所谓皮肤甲错,皮滞而不清泽也,皮肤枯燥或痛。治宜生血滋荣而润燥。脉右寸浮
涩。
主方 黄连 黄芩 当归 生地 麦冬(各钱半) 玄参 柴胡 秦艽 干葛(各一钱)
白芷(六分) 升麻 甘草(各四分) 上加生姜三片,葱头一寸,水煎热服,取微汗。
经曰∶诸痒为虚。盖肺主气,司皮毛,肺气不通,闭固郁热生风。宜清热疏风,凉血散郁,
服防风通圣散。盖出微汗;无汗,姜、葱、紫苏汤助。虚人中气不足,卫虚作痒,补中益气汤加
防、芎、芷。
主方 玄参 升麻 白芷(各一钱) 蝉蜕 防风 黄 川芎(各七分) 甘草(四
分) 上加葱白一寸,水煎服。
胡麻散 治风邪挟热,瘙痒及瘾疹等证。
草胡麻(二两) 苦参 荆芥 何首乌 威灵仙 防风 石菖蒲 牛蒡子 白蒺藜 蔓荆子
菊花(各一两) 甘草(五钱)
上为细末,每服二钱,薄荷汤或菜汤调下,水丸服亦可。
简便方 薄荷叶 蝉蜕(等分) 为末,每服二钱,酒下。
浴方 干荷叶、 本、甘松、白芷、灵仙、苍耳草、金银花藤煎汤,入煨盐一撮。
(附注:瘙痒)
《内经》说:十二经络的脉气,都分布于皮肤。各种疾病的发生,必定先从皮毛开始。邪气侵袭人体,腠理就会开泄;腠理开泄,邪气便侵入络脉;若邪气停留不去,就会传入经脉;若再停留不去,就会传入腑,最终影响肠胃。所以,皮肤有特定的分部,如果这些部位发生病变而不及时治疗,就会发展成大病。又说:肺主管皮毛,在脏属肺,在体合皮。因此,如果气不能濡养,皮毛就会干枯焦脆;如果津液耗损,指甲就会枯槁、毛发折断,甚至导致死亡。皮肤索泽,也就是所谓的“皮肤甲错”(皮肤干燥粗糙如鳞甲),表现为皮肤滞涩不清爽润泽,皮肤枯燥或疼痛。治疗应当采用生血滋荣、润燥的方法。脉象表现为右寸部浮而涩。
主方:黄连、黄芩、当归、生地、麦冬(各一钱半);玄参、柴胡、秦艽、干葛(各一钱);白芷(六分);升麻、甘草(各四分)。上方加生姜三片、葱头一寸,用水煎煮,热服,以微微出汗为度。
《内经》说:所有的瘙痒都属于虚证。因为肺主气,司管皮毛,肺气不通畅,闭塞固守,郁热内生而生风。适宜采用清热疏风、凉血散郁的方法,服用防风通圣散(Wind-Protecting Universal Powder),使微微出汗;如果没有汗出,可用生姜、葱白、紫苏汤来辅助发汗。对于中气不足的虚人,因卫气虚弱而作痒的,用补中益气汤(Tonify the Middle and Boost Qi Decoction)加入防风、川芎、白芷。
主方:玄参、升麻、白芷(各一钱);蝉蜕、防风、黄芩、川芎(各七分);甘草(四分)。上方加葱白一寸,用水煎服。
胡麻散:治疗风邪挟带热邪,引起的瘙痒及瘾疹等证候。
草胡麻(二两);苦参、荆芥、何首乌、威灵仙、防风、石菖蒲、牛蒡子、白蒺藜、蔓荆子、菊花(各一两);甘草(五钱)。
以上药物研成细末,每次服用二钱,用薄荷汤或菜汤调服,制成水丸服用也可以。
(Note: Pruritus)
The *Neijing* (Classic of Internal Medicine) states: The meridians of the twelve channels are distributed in the skin. The onset of various diseases always begins at the hair follicles and skin. When pathogenic factors invade, the interstices (*Couli*) open; once opened, pathogens enter the collaterals. If they remain there without being expelled, they transmit to the main meridians; if they still remain, they transmit to the fu organs, ultimately affecting the intestines and stomach. Therefore, the skin has specific regional distributions. If lesions occur in these regions and are not treated, major diseases will develop. It is also stated that the Lung governs the skin and hair; in the zang organs it corresponds to the Lung, and in the body structures it corresponds to the skin. Thus, if Qi fails to nourish, the skin and hair become dry and brittle; if body fluids are depleted, the nails wither and hair breaks off, potentially leading to death. "Skin suoze" refers to what is called "skin like armor scales" (*Jiacuo*), characterized by skin that is stagnant, unsmooth, and lacks luster, presenting as dryness or pain. Treatment should focus on generating blood, nourishing vitality, and moistening dryness. The pulse is floating and choppy at the right Cun position.
Main Formula: Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Tuber) (each 1.5 qian); Xuanshen (Scrophulariae Radix), Chaihu (Bupleuri Radix), Qinjiao (Gentianae Macrophyllae Radix), Gange (Puerariae Lobatae Radix) (each 1 qian); Baizhi (Angelicae Dahuricae Radix) (0.6 fen); Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.4 fen). Add three slices of Shengjiang (Zingiberis Rhizoma Recens) and one cun of Congtou (Allii Cepae Bulbus) to the above. Decoct in water, take hot, aiming for a slight sweating.
The *Neijing* states: All pruritus is due to deficiency. Since the Lung governs Qi and controls the skin and hair, if Lung Qi is obstructed, stagnation and solidification generate internal heat and wind. The treatment should clear heat and disperse wind, cool the blood and dissipate stagnation. Take Fangfeng Tongsheng San (Wind-Protecting Universal Powder) to induce slight sweating; if no sweat occurs, use Jiang (Zingiberis Rhizoma), Congbai (Allii Fistulosi Bulbus), and Zisu (Perillae Folium) decoction to assist. For deficient individuals with insufficient middle Qi, where defensive Qi deficiency causes itching, use Buzhong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) added with Fangfeng (Saposhnikoviae Radix), Xiong (Chuanxiong Rhizoma), and Baizhi (Angelicae Dahuricae Radix).
Main Formula: Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix) (each 1 qian); Chantui (Cicadae Periostracum), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Chuanxiong (Chuanxiong Rhizoma) (each 0.7 fen); Gancao (Glycyrrhizae Radix et Rhizoma) (0.4 fen). Add one cun of Congbai (Allii Fistulosi Bulbus) to the above. Decoct in water and take.
Huma San (Sesamum Powder): Treats pruritus and urticaria caused by wind-pathogen combined with heat.
Caohuma (Sesami Semen), Kushen (Sophorae Flavescentis Radix), Jingjie (Schizonepetae Spica), Heshouwu (Polygoni Multiflori Radix), Weilingxian (Clematidis Radix), Fangfeng (Saposhnikoviae Radix), Shichangpu (Acori Tatarinowii Rhizoma), Niubangzi (Arctii Fructus), Baijili (Tribuli Fructus), Manjingzi (Vitalbae Fructus), Juhua (Chrysanthemi Flos) (each 1 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (5 qian).
Grind the above into fine powder. Take 2 qian per dose, mixed with Bohe Tang (Menthae Haplocalycis Herba decoction) or vegetable soup. Taking it as water pills is also acceptable.
Simple Prescription: Bohe Ye (Menthae Haplocalycis Herba) and Chantui (Cicadae Periostracum) in equal parts. Grind into powder. Take 2 qian per dose, taken with wine.
Bath Prescription: Gan Heye (Nelumbinis Folium), Ben (Ligustici Rhizoma et Radix), Gansong (Nardostachyos Radix et Rhizoma), Baizhi (Angelicae Dahuricae Radix), Lingxian (Clematidis Radix), Cang'ercao (Xanthii Herba), Jinyinhua Teng (Lonicerae Japonicae Caulis et Flos) decocted in water, add a pinch of Weiyan (Calcined Salt).