例三于宫颈癌手术后产生不全性肠梗阻，并见头痛目眩，呕吐涎沫，食不得入，渴不欲饮，心中疼热等厥阴寒热夹杂、肝风扰胃，肝胃不和的症候，治以苦甘辛合剂一乌梅丸化裁，功能平调寒热、敛肝熄风，调和肝胃，清热化痰。全案辨证明晰，方证契合。
（二十八）天疱疮郑××，男，58岁。初诊日期：1977年7月18日。患者半年前先从躯干发生散在水疱，以后逐渐增多，大小不等，破后流水，久不愈合，自觉微痒，以后发展到四肢，迅即扩散到全身。曾在××医院诊为“寻常性天疱疮”给以“强的松”治疗，每日量30毫克，病情未能控制，后强的松每日量加到60毫克，病情稍有好转。但时轻时重，偶有新疱发生，延续数月，遂来我院治疗，来院时躯干、四肢仍有散在少数水疱及糜烂面，强的松每日量仍为60毫克。检查：一般情况尚好，体壮，面孔呈满月形，全身皮肤散在少数黄豆至蚕豆大的水疱，疱膜松弛，尼可氏征阳性，并见胸背部有多块指盖至五分钱硬币大的糜烂面，基底潮红，部分融合成片状，表面结有污灰色痂皮，口腔无损害，不发烧。苔白腻，脉弦滑微数。辨证：素有蕴湿，郁久化热（西医诊断：寻常性天疱疮）。治法：健脾除湿清热。方药：苡仁31克生扁豆15克生芡实12克冬瓜皮7克冬瓜仁7克六一散、川萆薢、绿豆衣、干地黄各31克莲子心12克苦参9克龙葵9克车前子、草各15克局部治疗：祛湿散
（方附后）100克，六一散100克，龟板散30克外扑。甘草油（方附后）清洁用。8月8日：前方进10剂，病情较前好转，但仍有新发水疱，便干。舌苔白兼腻，脉弦滑。仍用前法加减：加入大黄9克，桃仁3克，野菊花15克，连翘9克，白藓皮31克；去生芡实、干地黄、苦参、龙葵、六一散，再进10剂。强的松仍维持每日量60毫克。8月25日，皮损较前干燥，仍有少量新疱，大便已调，一般情况好，强的松每日量60毫克，舌苔白兼腻，脉弦微缓，前方不变，再进10剂。10月20日：病情稳定，未见新发疱疹，强的松每日量已减至15毫克，舌苔白，脉缓，改服丸药调理。除湿丸：每日6克。白术膏：每日一匙。参茸卫生丸：每日1／3丸。本例共服汤药60剂，历时92天。附方：
（1）法湿散：大黄面30克黄芩面30克寒水石面30克青黛面3克②甘草油：甘草10克植物油100毫升，甘草浸入植物油内一昼夜，文火炸至焦黄，离火滤过，去渣备用。
（3）白术散：单味白术炼蜜成膏。（《北京市老中医经验选编》赵炳南治案，张志礼等整理）
【评按】天疱疮以其疮形如水疱，皮薄而泽，发病又与天行时气（多为风热暑湿之邪）有关，故名。其发病内因多属心火，脾湿蕴蒸，常发于儿童。此案的治疗不论内服外治，均着重于除湿清热。但在治疗后期则适当照顾脾肾，培补先天、后天，有利于成人患者疔效的巩固。
（二十九）丹毒
例一应××，女，37岁。初诊日期：1972年4月27日。患者前天左足背及左小腿红肿胀痛，局部发热，行走时胀痛加剧；口渴，思冷饮，不思食，时而呕逆，尿短赤，大使三日未行，伴有发热。既往无类似病史。检查：体温39℃，呈昏睡状态，问之不语，表情痛苦，面赤唇焦；左足背及左小腿下1/3皮色红赤，形如云片，略肿，局部扪之的手。白细胞计数20，300／立方毫米。脉弦数一393一有力，舌尖红，苔黄。辨证：湿热下注，火毒攻心（左小腿丹毒）。治法：清热利湿，解毒护心。方药：银花24克公英24克大青叶10克连翘18克黄连6克生栀子10克归尾10克赤芍10克车前子10克生地20克猪苓10克灯芯炭10克薄荷3克川军10克（包）绿豆衣10克陈皮6克每日2剂，每六小时服一次。另服梅花点舌丹，每次一丸，每四小时一次。外用：外敷雄黄软膏，每日二次。4月12日
（复诊）：服上方3剂，神志清，呕逆已止，疼痛减轻，大便已通，稍能进食，局部皮肤赤红变浅。体温渐退（37℃），白细胞计数：12，000／立方毫米。舌苔薄黄，脉弦略数。依前方加减：银花20克公英25克连翘20克赤芍10克当归10克生栀子10克猪苓10克川军3克车前子10克牛膝10克甘草3克生地15克条芩10克黄连3克每日一付半，每八小时服药一次。外用：外敷芙蓉软膏，一日二次。4月15日（诊）：一切恢复正常，左足及左小腿皮色亦恢复正常。嘱继续按前方服药四剂，每日一剂，以巩固疗效。随访四年，未再复发。（《房芝萱外科经验》）
例二商××，男，47岁。病历号20092，初诊日期：1957年11月4日。患者近十年来每于感冒，劳累或步行过多后，左小腿即骤然掀红肿痛，同时恶寒身热，体温高达40℃左右。每次用抗菌素治疗后，病情始见平伏，初发时每半年发作一次，随后渐趋频繁，甚则每月发作二次。这次来诊已发病六天，右小腿焮红肿胀，灼热疼痛，体温39℃。左侧鼠蹊部淋巴结肿痛。脉象滑数，舌质红、苔黄。辨证：湿热下注，化为火毒，发为流火（西医诊断：慢性丹毒，急性发作）。治法：利湿清热，凉血解毒。方药：丹皮4．5克赤芍4．5克黄芩4．5克忍冬藤9克生苡仁9克泽泻9克二妙丸9克（包）六一散9克（包）赤苓9克大贝母9克水煎服。11月8日
（二诊）：服前方3剂后，红肿渐退，又继服二剂，改为每日口服二妙丸9克，共半月。服药期间，焮红肿胀全消而愈。一年半后追踪，丹毒未见复发。（《朱仁康临床经验集》
【评按】
例一、例二均生于胫腿部，一般称之为“流火”，例一辨证属湿热下注，火毒攻心，房氏治以清热利湿，解毒护心法为主，佐以凉血活血。另服梅花点舌丹（《外科全生集》方）及先后外敷雄黄软膏、芙蓉软膏者、功能消肿定痛。例二为慢性丹毒，反复发作已有10年，虽在治法上亦宜利湿清热、凉血解毒，但疏方与例一有所不同。朱氏治慢性丹毒，常用二妙丸入汤剂中煎服，而其主要经验是在急性发作后，继续常服苍术膏（有两种配方：①苍术1000克，②苍术1，000克，当归90克，白藓皮60克。制法：上药加水连熬三次取汁，文火煎成浓膏，加蜂蜜250克调和成膏），认为苍术健脾澡湿，能增强患者抗病力，防制其发作，亦即“缓则治其本”之意
（三十）蛇窜疮王××，女，33岁，病历号：11931。初诊日期1958年4月4日。左腰部及左大腿出现集簇小水疱，剧痛已三天。七天前左腰部及左大腿外侧出现大片红斑、小水疱、刺痛加重，不敢触碰，坐立不安，虽服止痛片亦未解痛。大便干结。检查：左侧腰部及沿左大腿外侧，相当于腰1～2节段，可见成片集簇之小水疱，部分为血疱，基底潮红。脉弦而带数，舌苔薄黄。诊断：蛇窜疮（西医诊断：带状疱疹）。辨证：心肝二经之火内郁。治法：泻心肝之火热。方药：川连9克黄芩9克焦山栀9克大青叶9克番泻叶9克银花9克连翘9克赤芍9克花粉9克青黛1．5克水煎服。外用玉露膏。4月6日
（二诊）：服二剂后，水疱已见结痂，刺痛明显减轻，大便三日未行，舌苔黄糙，脉弦数。方拟通腑泄热。生川军6克（后入）黄芩9克焦山栀6克大青叶6克连翘9克丹皮9克赤芍9克忍冬藤9克2剂。4月8日
（三诊）：疱疹大部干结，疼痛基本消失，大便畅通。前方去大黄加花粉9克。2剂后治愈。（《朱仁康临床经验集》）
【评按】蛇窜疮多发于腰肋部，又名缠腰蛇丹，西医名带状疱疹。中医认为多由心肝二经风火，或脾肺二经湿热所致。此案所用系清营泻火、凉血解毒法。后因患者便结，参入通腑泄热之品，辨证确而用药当。外用芙蓉膏，可加强清热缓痛之效，全案证方较为熨贴。
（三十一）湿疹
例一徐调，男，30岁。初诊日期：1971年4月12日。患者半月前腹部出现红色疙瘩，搔痒，晚间尤甚，搔后皮疹增大，流黄水，局部皮肤大片发红，逐渐延及腰部、躯干等处。诊断为急性湿疹。曾服“苯海拉明”，静脉注射“溴化钙”局部用醋洗均未见效。大便干，小便黄，口渴思饮。检查：胸背部皮肤轻度潮红，有散在红色小丘疹，自米粒大至高梁米粒大，下腹部及腰部呈大片集簇性排列，并掺杂有小水疱，部分丘疹顶部抓破有少量渗出液及结痂，臀部也有类似皮疹。脉沉细稍数，舌苔薄白。辨证：湿热蕴久化热，发为急性湿疡，热重于湿。治法：清热凉血利湿。方药：胆草9克黄芩9克栀子9克生地30克赤芍15克茵陈15克紫草根12克地肤子15克茅根15克生甘草6克上方服21剂后，皮疹逐渐消退，疹色变淡，腹部、股内侧偶尔出现红色小丘疹，兼见有风团样损害。按前法佐以养血凉肝之剂。胆草9克黄芩9克生地30克赤芍15克当归12克茵陈15克女贞子30克旱莲草12克刺蒺藜15克生甘草6克上方继服15剂，皮损消失，临床治愈。（《赵炳南临床经验集》）
例二张某某，男，47岁，初诊日期1971年3月23日。患者六年前开始全身泛发暗红色丘疹。检查：全身泛发暗红丘疹，除面部外，全身皮肤粗糙、角化，皮纹理增粗、肥厚，有色素沉着，呈深褐色，散在明显的抓痕血痂，脉弦滑，舌苔白腻、舌质红。辨证：湿毒内蕴，发于肌肤（西医诊断为泛发性湿疹）。洽法：除湿润肤，解毒止痒。方药：全虫9克白藓皮45克地肤子30至川槿皮9克干生地30克威灵仙15克槐花30克苍耳子9克苦参15克陈皮6克外用龙胆草90克豨莶草30克川椒9克。水煎，外洗。4月3日，服药三剂后，痒稍有缓解。其余未见好转，改用清热除湿法，龙胆泻肝汤加减：龙胆草15克川军12克黄柏12克黄芩12克川槿皮30克生白术15克赤苓皮15克白藓皮60克干生地30克生槐花30克苍耳子9克。外用大枫子油2瓶，如意金黄散4袋，外扑。5月5日前服10余剂，变化不大，改用秦艽丸方加减：秦艽15克乌蛇9克防风9克黄芪15克苦参15克漏芦9克黄连6克白藓皮30克威灵仙30克连续服用20余剂，明显好转，皮损面变薄、转软化，搔痒基本消失。以后改用秦艽丸服半月余，6月中旬复诊时，全身皮肤已恢复正常，痒止，近期临床治愈。（《赵炳南临床经验集》）
例三朱××，女，32岁，病历号：129809，初诊日期：1967年1月3日。一月来先于脸颊皮肤潮红、浸润，并见细薄鳞屑。脉弦细，舌淡、苔薄布。辨证：面游风，风燥伤血
（西医诊断：脂溢性湿疹）。治法：养血祛风。方药：生熟地各9克丹参9克荆芥9克苦参9克白藓皮9克枇杷叶9至桑白皮9克忍冬藤9至生甘草6克五剂。外用青白散香油调搽。1月9日
（二诊）：药后，脸面脱屑减少，瘙痒亦见明显减轻，但双前臂又见新起斑丘疹，近日来腰疼，转侧不利。仍宗前方去忍冬藤，加川断9克，狗脊9克，再服5剂，基本治愈。青白散：青黛30克，海螵蛸末90克，煅石膏末370克，冰片3克，先将青黛研细，次加海螵蛸末研和，后加煅石膏末研和；冰片入研钵内轻轻研细，加入上药少许研和，再加全部药末研和用。（《朱仁康临床经验集》）
【评按】湿疹多由风湿热邪客于肌肤所致，病久则易耗血、生风生燥，风燥郁滞则肌肤失荣，而使湿疹呈现慢性发作的情况。例一为急性湿疹，辨证属湿热蕴久化热，由于热重于湿，故治以清热凉血利湿法，后佐以凉肝之品。证方贴切。例二为慢性继发性湿疹，剧痒6年，初诊辨证为湿毒内蕴，洽以清化湿毒为主，佐以养营通络之品，曾一度用龙胆泻肝汤治疗乏效，后治以祛风通络为主，清化湿热为辅，方用秦艽丸（《证治准绳》方）加减而效。此案三易其方，以患者全身泛发，皮损剧痒，说明邪郁干表不散为其主要矛盾，湿毒为次要矛盾，故改秦艽丸加减，例三为脂溢性湿疹，发于面部者，中医名为“面游风”，证属风燥伤血。治以养血润燥，消风止痒，方治颇为对证。外用青白散有收湿止痒、消炎退肿之效，除主治湿疹外，亦可用于过敏性皮炎。
（三十二）风癣杜××，女，39岁，工人，病历号：217683。初诊日期：1967年8月24日。全身泛发皮癣二年。二年来先后干颈后，两时伸侧、下肢等处起成片皮癣，瘙痒无度，昼轻暮重，难于入眠，屡治无效。皮肤检查：颈后、双时伸侧、前胸、下肢等处，有较为对称成片轻度苔藓化皮损，呈淡红色，瘙痕累累，结有血痂，稍见溢水。脉弦细，苔黄腻。辨证：风癣，血热内盛，风胜化燥（西医诊断：泛发性神经性皮炎）。洽法：凉血清热，消风止痒。方药：皮癣汤（经验方）加减。生地15克丹参9克赤芍9克荆芥9克防风6克茜草9克马尾连9克黄芩9克苍耳子9克白藓皮9克地肤子9克水煎服，每日：剂，二次分服。8月31日
病例三：患者在宫颈癌手术后出现不全性肠梗阻，并伴有头痛、目眩、呕吐涎沫、无法进食、口渴但不想喝水、心中疼痛且有灼热感等症状。此为厥阴病寒热错杂、肝风扰动胃腑、肝胃不和的证候。治疗采用苦甘辛合剂——乌梅丸加减，功效在于平调寒热、收敛肝气平息肝风、调和肝胃、清热化痰。全案辨证清晰，方药与证候契合。
（二十八）天疱疮 患者郑某某，男性，58岁。初诊日期：1977年7月18日。患者半年前躯干首先出现散在的水疱，随后逐渐增多，大小不一，破溃后流水，久不愈合，自觉轻微瘙痒，之后发展至四肢，迅速扩散至全身。曾在某医院诊断为“寻常型天疱疮”，给予“强的松”治疗，每日剂量30毫克，病情未能控制；后强的松每日剂量增至60毫克，病情稍有好转。但病情时轻时重，偶有新水疱发生，延续数月，遂来我院治疗。就诊时躯干、四肢仍有散在的少数水疱及糜烂面，强的松每日剂量仍为60毫克。检查：一般情况尚可，体格壮实，面容呈满月形，全身皮肤散在分布黄豆至蚕豆大小的水疱，疱壁松弛，尼氏征（Nikolsky sign）阳性，胸背部有多块指盖至五分钱硬币大小的糜烂面，基底潮红，部分融合成片状，表面结有污灰色痂皮，口腔无损害，无发热。舌苔白腻，脉弦滑微数。辨证：素有湿邪蕴结，郁久化热（西医诊断：寻常型天疱疮）。治法：健脾除湿清热。方药：生薏苡仁31克，生扁豆15克，生芡实12克，冬瓜皮7克，冬瓜仁7克，六一散、川萆薢、绿豆衣、干地黄各31克，莲子心12克，苦参9克，龙葵9克，车前子、车前草各15克。局部治疗：祛湿散（方附后）100克，六一散100克，龟板散30克，外扑。甘草油（方附后）用于清洁。8月8日：服用前方10剂，病情较前好转，但仍有新发水疱，大便干燥。舌苔白兼腻，脉弦滑。仍用前法加减：加入大黄9克，桃仁3克，野菊花15克，连翘9克，白鲜皮31克；去掉生芡实、干地黄、苦参、龙葵、六一散，再进10剂。强的松维持每日60毫克。8月25日，皮损较前干燥，仍有少量新疱，大便已调畅，一般情况良好，强的松每日剂量60毫克，舌苔白兼腻，脉弦微缓，前方不变，再进10剂。10月20日：病情稳定，未见新发疱疹，强的松每日剂量已减至15毫克，舌苔白，脉缓，改服丸药调理。除湿丸：每日6克。白术膏：每日一匙。参茸卫生丸：每日1/3丸。本例共服汤药60剂，历时92天。附方：
（1）祛湿散：大黄粉30克，黄芩粉30克，寒水石粉30克，青黛粉3克。
（2）甘草油：甘草10克，植物油100毫升，将甘草浸入植物油内一昼夜，文火炸至焦黄，离火滤过，去渣备用。
（3）白术散：单味白术炼蜜成膏。（《北京市老中医经验选编》赵炳南治案，张志礼等整理）
【评按】天疱疮因其疮形如水疱，皮薄而润泽，发病又与天时气候（多为风热暑湿之邪）有关，故名。其发病内因多属心火，脾湿蕴蒸，常发于儿童。此案的治疗不论内服外治，均着重于除湿清热。但在治疗后期则适当照顾脾肾，培补先天、后天，有利于成人患者疗效的巩固。
（二十九）丹毒
病例一 患者应某某，女性，37岁。初诊日期：1972年4月27日。患者前天左足背及左小腿红肿胀痛，局部发热，行走时胀痛加剧；口渴，想喝冷饮，不思饮食，时而呕逆，尿短赤，大便三日未行，伴有发热。既往无类似病史。检查：体温39℃，呈昏睡状态，问之不答，表情痛苦，面赤唇焦；左足背及左小腿下1/3皮色红赤，形如云片，略肿，局部触之烫手。白细胞计数20,300/立方毫米。脉弦数有力，舌尖红，苔黄。辨证：湿热下注，火毒攻心（左小腿丹毒）。治法：清热利湿，解毒护心。方药：金银花24克，蒲公英24克，大青叶10克，连翘18克，黄连6克，生栀子10克，当归尾10克，赤芍10克，车前子10克，生地20克，猪苓10克，灯芯炭10克，薄荷3克，川军（大黄）10克（包煎），绿豆衣10克，陈皮6克。每日2剂，每六小时服一次。另服梅花点舌丹，每次一丸，每四小时一次。外用：外敷雄黄软膏，每日二次。4月12日（复诊）：服用上方3剂，神志清醒，呕逆已止，疼痛减轻，大便已通，稍能进食，局部皮肤赤红变浅。体温渐退（37℃），白细胞计数：12,000/立方毫米。舌苔薄黄，脉弦略数。依前方加减：金银花20克，蒲公英25克，连翘20克，赤芍10克，当归10克，生栀子10克，猪苓10克，川军3克，车前子10克，牛膝10克，甘草3克，生地15克，条芩（黄芩）10克，黄连3克。每日一付半，每八小时服药一次。外用：外敷芙蓉软膏，一日二次。4月15日（诊）：一切恢复正常，左足及左小腿皮色亦恢复正常。嘱继续按前方服药四剂，每日一剂，以巩固疗效。随访四年，未再复发。（《房芝萱外科经验》）
病例二 患者商某某，男性，47岁。病历号20092，初诊日期：1957年11月4日。患者近十年来每于感冒、劳累或步行过多后，左小腿即骤然掀红肿痛，同时恶寒身热，体温高达40℃左右。每次用抗菌素治疗后，病情始见平伏，初发时每半年发作一次，随后渐趋频繁，甚则每月发作二次。这次来诊已发病六天，右小腿焮红肿胀，灼热疼痛，体温39℃。左侧鼠蹊部淋巴结肿痛。脉象滑数，舌质红、苔黄。辨证：湿热下注，化为火毒，发为流火（西医诊断：慢性丹毒，急性发作）。治法：利湿清热，凉血解毒。方药：丹皮4.5克，赤芍4.5克，黄芩4.5克，忍冬藤9克，生苡仁9克，泽泻9克，二妙丸9克（包煎），六一散9克（包煎），赤苓9克，大贝母9克，水煎服。11月8日（二诊）：服用前方3剂后，红肿渐退，又继服二剂，改为每日口服二妙丸9克，共半月。服药期间，焮红肿胀全消而愈。一年半后追踪，丹毒未见复发。（《朱仁康临床经验集》）
【评按】
病例一、病例二均生于胫腿部，一般称之为“流火”，病例一辨证属湿热下注，火毒攻心，房氏治以清热利湿，解毒护心法为主，佐以凉血活血。另服梅花点舌丹（《外科全生集》方）及先后外敷雄黄软膏、芙蓉软膏者，功能消肿定痛。病例二为慢性丹毒，反复发作已有10年，虽在治法上亦宜利湿清热、凉血解毒，但疏方与病例一有所不同。朱氏治慢性丹毒，常用二妙丸入汤剂中煎服，而其主要经验是在急性发作后，继续常服苍术膏（有两种配方：①苍术1000克，②苍术1,000克，当归90克，白藓皮60克。制法：上药加水连熬三次取汁，文火煎成浓膏，加蜂蜜250克调和成膏），认为苍术健脾燥湿，能增强患者抗病力，防制其发作，亦即“缓则治其本”之意。
（三十）蛇窜疮 患者王某某，女性，33岁，病历号：11931。初诊日期1958年4月4日。左腰部及左大腿出现集簇小水疱，剧痛已三天。七天前左腰部及左大腿外侧出现大片红斑、小水疱，刺痛加重，不敢触碰，坐立不安，虽服止痛片亦未解痛。大便干结。检查：左侧腰部及沿左大腿外侧，相当于腰1～2节段，可见成片集簇之小水疱，部分为血疱，基底潮红。脉弦而带数，舌苔薄黄。诊断：蛇窜疮（西医诊断：带状疱疹）。辨证：心肝二经之火内郁。治法：泻心肝之火热。方药：川连9克，黄芩9克，焦山栀9克，大青叶9克，番泻叶9克，银花9克，连翘9克，赤芍9克，花粉9克，青黛1.5克，水煎服。外用玉露膏。4月6日（二诊）：服用二剂后，水疱已见结痂，刺痛明显减轻，大便三日未行，舌苔黄糙，脉弦数。方拟通腑泄热。生川军6克（后入），黄芩9克，焦山栀6克，大青叶6克，连翘9克，丹皮9克，赤芍9克，忍冬藤9克，2剂。4月8日（三诊）：疱疹大部干结，疼痛基本消失，大便畅通。前方去大黄加花粉9克。2剂后治愈。（《朱仁康临床经验集》）
【评按】蛇窜疮多发于腰肋部，又名缠腰蛇丹，西医名带状疱疹。中医认为多由心肝二经风火，或脾肺二经湿热所致。此案所用系清营泻火、凉血解毒法。后因患者便结，参入通腑泄热之品，辨证确而用药当。外用芙蓉膏，可加强清热缓痛之效，全案证方较为熨贴。
（三十一）湿疹
病例一 徐某，男性，30岁。初诊日期：1971年4月12日。患者半月前腹部出现红色疙瘩，搔痒，晚间尤甚，搔后皮疹增大，流黄水，局部皮肤大片发红，逐渐延及腰部、躯干等处。诊断为急性湿疹。曾服“苯海拉明”，静脉注射“溴化钙”，局部用醋洗均未见效。大便干，小便黄，口渴思饮。检查：胸背部皮肤轻度潮红，有散在红色小丘疹，自米粒大至高梁米粒大，下腹部及腰部呈大片集簇性排列，并掺杂有小水疱，部分丘疹顶部抓破有少量渗出液及结痂，臀部也有类似皮疹。脉沉细稍数，舌苔薄白。辨证：湿热蕴久化热，发为急性湿疡，热重于湿。治法：清热凉血利湿。方药：胆草9克，黄芩9克，栀子9克，生地30克，赤芍15克，茵陈15克，紫草根12克，地肤子15克，茅根15克，生甘草6克。上方服21剂后，皮疹逐渐消退，疹色变淡，腹部、股内侧偶尔出现红色小丘疹，兼见有风团样损害。按前法佐以养血凉肝之剂。胆草9克，黄芩9克，生地30克，赤芍15克，当归12克，茵陈15克，女贞子30克，旱莲草12克，刺蒺藜15克，生甘草6克。上方继服15剂，皮损消失，临床治愈。（《赵炳南临床经验集》）
病例二 张某某，男性，47岁，初诊日期1971年3月23日。患者六年前开始全身泛发暗红色丘疹。检查：全身泛发暗红丘疹，除面部外，全身皮肤粗糙、角化，皮纹理增粗、肥厚，有色素沉着，呈深褐色，散在明显的抓痕血痂，脉弦滑，舌苔白腻、舌质红。辨证：湿毒内蕴，发于肌肤（西医诊断为泛发性湿疹）。治法：除湿润肤，解毒止痒。方药：全虫9克，白藓皮45克，地肤子30至川槿皮9克，干生地30克，威灵仙15克，槐花30克，苍耳子9克，苦参15克，陈皮6克。外用龙胆草90克，豨莶草30克，川椒9克。水煎，外洗。4月3日，服药三剂后，痒稍有缓解。其余未见好转，改用清热除湿法，龙胆泻肝汤加减：龙胆草15克，川军12克，黄柏12克，黄芩12克，川槿皮30克，生白术15克，赤苓皮15克，白藓皮60克，干生地30克，生槐花30克，苍耳子9克。外用大枫子油2瓶，如意金黄散4袋，外扑。5月5日前服10余剂，变化不大，改用秦艽丸方加减：秦艽15克，乌蛇9克，防风9克，黄芪15克，苦参15克，漏芦9克，黄连6克，白藓皮30克，威灵仙30克。连续服用20余剂，明显好转，皮损面变薄、转软化，搔痒基本消失。以后改用秦艽丸服半月余，6月中旬复诊时，全身皮肤已恢复正常，痒止，近期临床治愈。（《赵炳南临床经验集》）
病例三 朱某某，女性，32岁，病历号：129809，初诊日期：1967年1月3日。一月来先于脸颊皮肤潮红、浸润，并见细薄鳞屑。脉弦细，舌淡、苔薄布。辨证：面游风，风燥伤血（西医诊断：脂溢性湿疹）。治法：养血祛风。方药：生熟地各9克，丹参9克，荆芥9克，苦参9克，白藓皮9克，枇杷叶9至桑白皮9克，忍冬藤9至生甘草6克，五剂。外用青白散香油调搽。1月9日（二诊）：药后，脸面脱屑减少，瘙痒亦见明显减轻，但双前臂又见新起斑丘疹，近日来腰疼，转侧不利。仍宗前方去忍冬藤，加川断9克，狗脊9克，再服5剂，基本治愈。青白散：青黛30克，海螵蛸末90克，煅石膏末370克，冰片3克，先将青黛研细，次加海螵蛸末研和，后加煅石膏末研和；冰片入研钵内轻轻研细，加入上药少许研和，再加全部药末研和用。（《朱仁康临床经验集》）
【评按】湿疹多由风湿热邪客于肌肤所致，病久则易耗血、生风生燥，风燥郁滞则肌肤失荣，而使湿疹呈现慢性发作的情况。病例一为急性湿疹，辨证属湿热蕴久化热，由于热重于湿，故治以清热凉血利湿法，后佐以凉肝之品。证方贴切。病例二为慢性继发性湿疹，剧痒6年，初诊辨证为湿毒内蕴，洽以清化湿毒为主，佐以养营通络之品，曾一度用龙胆泻肝汤治疗乏效，后治以祛风通络为主，清化湿热为辅，方用秦艽丸（《证治准绳》方）加减而效。此案三易其方，以患者全身泛发，皮损剧痒，说明邪郁于表不散为其主要矛盾，湿毒为次要矛盾，故改秦艽丸加减，病例三为脂溢性湿疹，发于面部者，中医名为“面游风”，证属风燥伤血。治以养血润燥，消风止痒，方治颇为对证。外用青白散有收湿止痒、消炎退肿之效，除主治湿疹外，亦可用于过敏性皮炎。
（三十二）风癣 杜某某，女性，39岁，工人，病历号：217683。初诊日期：1967年8月24日。全身泛发皮癣二年。二年来先后于颈后，两肘伸侧、下肢等处起成片皮癣，瘙痒无度，昼轻暮重，难于入眠，屡治无效。皮肤检查：颈后、双肘伸侧、前胸、下肢等处，有较为对称成片轻度苔藓化皮损，呈淡红色，瘙痕累累，结有血痂，稍见溢水。脉弦细，苔黄腻。辨证：风癣，血热内盛，风胜化燥（西医诊断：泛发性神经性皮炎）。治法：凉血清热，消风止痒。方药：皮癣汤（经验方）加减。生地15克，丹参9克，赤芍9克，荆芥9克，防风6克，茜草9克，马尾连9克，黄芩9克，苍耳子9克，白藓皮9克，地肤子9克，水煎服，每日2剂，二次分服。8月31日
Case 3: The patient developed an incomplete intestinal obstruction after surgery for cervical cancer, accompanied by headache, dizziness, vomiting of saliva and foam, inability to eat, thirst without desire to drink, and pain with burning sensation in the epigastrium. This presents as a syndrome of cold-heat complex in Jueyin (Jueyin disease), liver wind disturbing the stomach, and disharmony between the liver and stomach. Treatment employed Bitter-Sweet-Acrid Mixture—Wumei Wan (Mume Pill) modified, with functions of harmonizing cold and heat, astringing the liver and extinguishing wind, harmonizing the liver and stomach, clearing heat and resolving phlegm. The differentiation was clear, and the prescription matched the syndrome.
(28) Pemphigus vulgaris Patient Zheng XX, male, 58 years old. First visit date: July 18, 1977. Half a year ago, scattered blisters first appeared on the trunk, gradually increasing in number, varying in size, weeping fluid upon rupture, and failing to heal for a long time. The patient felt slight itching. Later, it spread to the limbs and rapidly diffused over the whole body. Previously diagnosed as "vulgar pemphigus" at a certain hospital, treated with Prednisone at 30 mg daily, but the condition was not controlled. Later, the daily dose of Prednisone was increased to 60 mg, and the condition improved slightly. However, the condition fluctuated, with occasional new blisters appearing, lasting for several months, so the patient came to our hospital for treatment. Upon arrival, there were still scattered few blisters and erosions on the trunk and limbs, and the daily dose of Prednisone remained at 60 mg. Examination: General condition was acceptable, physique was robust, face presented moon-shaped appearance, scattered blisters ranging from soybean to broad bean size were distributed on the skin of the whole body, blister walls were lax, Nikolsky sign was positive, there were multiple erosions the size of fingernails to five-cent coins on the chest and back, with red bases, partially fused into patches, covered with dirty gray crusts, no oral lesions, and no fever. Tongue coating was white and greasy, pulse was wiry, slippery, and slightly rapid. Differentiation: Accumulated dampness internally, stagnating for a long time transforming into heat (Western diagnosis: Vulgar pemphigus). Therapeutic method: Invigorate spleen, eliminate dampness, and clear heat. Prescription: Raw Coix Seed 31g, Raw Lablab Bean 15g, Raw Euryale Seed 12g, Winter Melon Peel 7g, Winter Melon Kernel 7g, Liu Yi San (Six-to-One Powder), Rhizoma Dioscoreae Hypoglaucae, Mung Bean Coat, Dry Rehmannia Root each 31g, Lotus Plumule 12g, Sophora Root Bark 9g, Solanum lyratum 9g, Plantago Seed and Herb each 15g. Local treatment: Qu Shi San (Dampness-Removing Powder, formula attached later) 100g, Liu Yi San 100g, Tortoise Shell Powder 30g, applied externally. Licorice Oil (formula attached later) for cleaning. August 8: After taking 10 doses of the previous prescription, the condition improved compared to before, but new blisters still appeared, and stool was dry. Tongue coating was white and greasy, pulse was wiry and slippery. Continue with the previous method with modifications: Add Rhubarb 9g, Peach Kernel 3g, Wild Chrysanthemum 15g, Forsythia Fruit 9g, Dictamnus Root Bark 31g; remove Euryale Seed, Dry Rehmannia Root, Sophora Root Bark, Solanum lyratum, Liu Yi San, and take another 10 doses. Maintain Prednisone at 60 mg daily. August 25: Skin lesions were drier than before, with only a small number of new blisters, stool was regulated, general condition was good, Prednisone daily dose was 60 mg, tongue coating was white and greasy, pulse was wiry, slightly slow, keep the previous prescription unchanged, take another 10 doses. October 20: Condition stabilized, no new herpes appeared, Prednisone daily dose reduced to 15 mg, tongue coating was white, pulse was slow, change to pill medication for regulation. Chu Shi Wan (Dampness-Removing Pill): 6g daily. Baizhu Gao (Atractylodes Macrocephala Paste): One spoon daily. Shenrong Weisheng Wan (Ginseng and Deer Antler Health Pill): 1/3 pill daily. This case took a total of 60 doses of decoction, lasting 92 days. Attached Formulas:
(1) Qu Shi San: Rhubarb powder 30g, Scutellaria Root powder 30g, Aragonite powder 30g, Indigo Naturalis powder 3g.
(2) Licorice Oil: Licorice Root 10g, Vegetable oil 100ml, soak Licorice Root in vegetable oil overnight, fry over gentle fire until scorched yellow, remove from fire, filter, discard residue for future use.
(3) Baizhu San: Single herb Atractylodes Macrocephala processed with honey into paste. (Selected Experiences of Senior TCM Practitioners in Beijing, Case records of Zhao Bingnan, organized by Zhang Zhili et al.)
[Commentary] Pemphigus is named so because its lesions resemble water blisters, with thin and shiny skin, and its onset is related to seasonal climate (mostly wind-heat, summer-heat, and dampness pathogens). Its internal cause is mostly heart fire and steaming spleen dampness, often occurring in children. The treatment of this case, whether internal or external, focuses on eliminating dampness and clearing heat. In the later stage of treatment, attention is paid to the spleen and kidney, nourishing congenital and acquired foundations, which helps consolidate the curative effect for adult patients.
(29) Erysipelas
Case 1 Patient Ying XX, female, 37 years old. First visit date: April 27, 1972. The day before yesterday, the dorsum of the left foot and lower left leg became red, swollen, painful, and locally hot; swelling and pain worsened when walking; thirsty, desiring cold drinks, loss of appetite, occasional vomiting, short and dark urine, no bowel movement for three days, accompanied by fever. No similar medical history. Examination: Temperature 39°C, in a comatose state, unresponsive to questions, expression of pain, red face and scorched lips; the dorsum of the left foot and lower 1/3 of the left lower leg were red, shaped like cloud patches, slightly swollen, hot to touch. White blood cell count 20,300/mm³. Pulse wiry, rapid, and forceful, tip of tongue red, coating yellow. Differentiation: Damp-heat pouring downward, fire-toxin attacking the heart (Erysipelas of the left lower leg). Therapeutic method: Clear heat, promote diuresis to eliminate dampness, detoxify, and protect the heart. Prescription: Honeysuckle Flower 24g, Dandelion 24g, Isatis Leaf 10g, Forsythia Fruit 18g, Coptis Rhizome 6g, Raw Gardenia Fruit 10g, Angelica Sinensis Tail 10g, Red Peony Root 10g, Plantago Seed 10g, Rehmannia Root 20g, Polyporus 10g, Charred Juncus Effusus 10g, Mint 3g, Rhubarb 10g (wrapped), Mung Bean Coat 10g, Tangerine Peel 6g. Two doses per day, taken every six hours. Also take Meihua Diandan (Plum Blossom Pointing Tongue Pill), one pill each time, every four hours. External application: Apply Realgar Ointment externally, twice daily. April 12 (Follow-up): After taking 3 doses of the above prescription, consciousness cleared, vomiting stopped, pain relieved, bowel movement resumed, able to eat slightly, local skin redness faded. Temperature gradually decreased (37°C), white blood cell count: 12,000/mm³. Tongue coating thin yellow, pulse wiry and slightly rapid. Modify according to the previous prescription: Honeysuckle Flower 20g, Dandelion 25g, Forsythia Fruit 20g, Red Peony Root 10g, Angelica Sinensis 10g, Raw Gardenia Fruit 10g, Polyporus 10g, Rhubarb 3g, Plantago Seed 10g, Achyranthes Root 10g, Licorice Root 3g, Rehmannia Root 15g, Scutellaria Root 10g, Coptis Rhizome 3g. Take half a dose daily, medicine every eight hours. External application: Apply Hibiscus Ointment externally, twice daily. April 15 (Visit): Everything returned to normal, skin color of the left foot and lower leg also returned to normal. Advised to continue taking four doses of the previous prescription, one dose daily, to consolidate the curative effect. Followed up for four years, no recurrence. (Surgical Experience of Fang Zhixuan)
Case 2 Patient Shang XX, male, 47 years old. Medical record number 20092, first visit date: November 4, 1957. For the past ten years, after catching a cold, fatigue, or excessive walking, the left lower leg would suddenly become red, swollen, and painful, accompanied by aversion to cold and fever, with temperature reaching around 40°C. Each time treated with antibiotics, the condition would subside. Initially occurring once every half year, then becoming more frequent, even twice a month. This time, the patient had been ill for six days, with the right lower leg red, swollen, burning, and painful, temperature 39°C. Swollen and painful lymph nodes in the left inguinal region. Pulse slippery and rapid, tongue body red, coating yellow. Differentiation: Damp-heat pouring downward, transforming into fire-toxin, manifesting as Liuhuo (Western diagnosis: Chronic erysipelas, acute exacerbation). Therapeutic method: Promote diuresis to eliminate dampness, clear heat, cool blood, and detoxify. Prescription: Moutan Cortex 4.5g, Red Peony Root 4.5g, Scutellaria Root 4.5g, Honeysuckle Stem 9g, Raw Coix Seed 9g, Alisma Rhizome 9g, Ermiao Wan (Two Marvels Pill) 9g (wrapped), Liu Yi San 9g (wrapped), Red Poria 9g, Large Fritillaria Bulb 9g, decoct in water and take orally. November 8 (Second visit): After taking 3 doses of the previous prescription, redness and swelling gradually subsided, continued taking 2 more doses, then changed to taking Ermiao Wan 9g orally daily for half a month. During the medication period, redness and swelling completely disappeared and healed. Tracked one and a half years later, no recurrence of erysipelas. (Clinical Experience Collection of Zhu Renkang)
[Commentary]
Cases 1 and 2 both occurred on the shank and calf, generally called "Liuhuo". Case 1 was differentiated as damp-heat pouring downward and fire-toxin attacking the heart. Dr. Fang treated mainly with clearing heat, promoting diuresis to eliminate dampness, detoxifying, and protecting the heart, supplemented by cooling blood and invigorating blood. Additionally, Meihua Diandan (Formula from Waike Quansheng Ji) was taken, and Realgar Ointment and Hibiscus Ointment were applied externally in sequence, functioning to reduce swelling and relieve pain. Case 2 was chronic erysipelas, recurring for 10 years. Although the therapeutic method should also be promoting diuresis to eliminate dampness, clearing heat, cooling blood, and detoxifying, the prescription differed from Case 1. Dr. Zhu commonly used Ermiao Wan added to decoctions for treating chronic erysipelas, and his main experience was continuing to take Cangzhu Gao (Cyperus Paste) after acute exacerbation (two formulas: ① Cyperus Rhizome 1000g, ② Cyperus Rhizome 1000g, Angelica Sinensis 90g, Dictamnus Root Bark 60g. Preparation: Decoct the herbs in water three times, collect juice, simmer over gentle fire to make thick paste, mix with 250g honey to form paste). He believed that Cyperus Rhizome strengthens the spleen and dries dampness, enhancing the patient's resistance and preventing recurrence, embodying the principle of "treating the root when the condition is stable".
(30) Herpes Zoster Patient Wang XX, female, 33 years old, medical record number: 11931. First visit date: April 4, 1958. Clusters of small blisters appeared on the left waist and left thigh, with severe pain for three days. Seven days ago, large red patches and small blisters appeared on the left waist and lateral left thigh, stabbing pain intensified, afraid to touch, restless, painkillers did not relieve pain. Stool was dry. Examination: On the left waist and along the lateral left thigh, corresponding to the L1-L2 segment,成片 clusters of small blisters were visible, some were hemorrhagic blisters, with red bases. Pulse wiry and slightly rapid, tongue coating thin yellow. Diagnosis: Shechuang Chuang (Western diagnosis: Herpes Zoster). Differentiation: Internal depression of fire in the Heart and Liver meridians. Therapeutic method: Drain fire and heat of the Heart and Liver. Prescription: Coptis Rhizome 9g, Scutellaria Root 9g, Charred Gardenia Fruit 9g, Isatis Leaf 9g, Senna Leaf 9g, Honeysuckle Flower 9g, Forsythia Fruit 9g, Red Peony Root 9g, Trichosanthes Root 9g, Indigo Naturalis 1.5g, decoct in water and take orally. External application: Yulu Gao (Jade Dew Paste). April 6 (Second visit): After taking two doses, blisters began to scab, stabbing pain significantly reduced, no bowel movement for three days, tongue coating yellow and rough, pulse wiry and rapid. Formula intended to purgatively drain heat. Raw Rhubarb 6g (added later), Scutellaria Root 9g, Charred Gardenia Fruit 6g, Isatis Leaf 6g, Forsythia Fruit 9g, Moutan Cortex 9g, Red Peony Root 9g, Honeysuckle Stem 9g, 2 doses. April 8 (Third visit): Most herpes vesicles dried and crusted, pain basically disappeared, bowel movement smooth. Remove Rhubarb from previous prescription, add Trichosanthes Root 9g. Cured after 2 doses. (Clinical Experience Collection of Zhu Renkang)
[Commentary] Shechuang Chuang (Herpes Zoster) mostly occurs in the waist and rib area, also known as Waist-Coiling Snake Dan, Western name Herpes Zoster. TCM believes it is mostly caused by wind-fire of the Heart and Liver meridians, or damp-heat of the Spleen and Lung meridians. The method used in this case was clearing nutritive level, draining fire, cooling blood, and detoxifying. Because the patient had constipation, ingredients for purgatively draining heat were added. The differentiation was accurate and medication appropriate. External application of Hibiscus Paste can strengthen the effects of clearing heat and relieving pain. The syndrome and prescription in the whole case were quite fitting.
(31) Eczema
Case 1 Xu Mou, male, 30 years old. First visit date: April 12, 1971. Half a month ago, red bumps appeared on the abdomen, itching, especially worse at night, rash enlarged after scratching, oozing yellow fluid, large areas of local skin redness, gradually extending to the waist, trunk, etc. Diagnosed as acute eczema. Previously taken Diphenhydramine, intravenous injection of Calcium Bromide, local washing with vinegar, all ineffective. Stool dry, urine yellow, thirsty desiring to drink. Examination: Mild flushing of skin on chest and back, scattered red papules ranging from rice grain to sorghum grain size, arranged in large clusters on the lower abdomen and waist, mixed with small blisters, some papule tops scratched open with slight exudate and crusting, similar rashes on buttocks. Pulse deep, fine, slightly rapid, tongue coating thin white. Differentiation: Damp-heat accumulated for a long time transforming into heat, manifesting as acute wet eczema, heat heavier than dampness. Therapeutic method: Clear heat, cool blood, and promote diuresis to eliminate dampness. Prescription: Gentian Root 9g, Scutellaria Root 9g, Gardenia Fruit 9g, Rehmannia Root 30g, Red Peony Root 15g, Yinchen (Artemisia Capillaris) 15g, Purple Coral Root 12g, Kochia Fruit 15g, Imperata Rhizome 15g, Raw Licorice Root 6g. After taking 21 doses of the above prescription, rash gradually subsided, color faded, occasionally red small papules appeared on abdomen and inner thigh, accompanied by urticaria-like lesions. According to the previous method, supplement with blood-nourishing and liver-cooling agents. Gentian Root 9g, Scutellaria Root 9g, Rehmannia Root 30g, Red Peony Root 15g, Angelica Sinensis 12g, Artemisia Capillaris 15g, Ligustrum Lucidum Fruit 30g, Eclipta Herb 12g, Tribulus Fruit 15g, Raw Licorice Root 6g. Continued taking 15 doses of the above prescription, skin lesions disappeared, clinically cured. (Clinical Experience Collection of Zhao Bingnan)
Case 2 Zhang XX, male, 47 years old, first visit date: March 23, 1971. Six years ago, diffuse dark red papules began to appear all over the body. Examination: Diffuse dark red papules all over the body, except for the face, skin rough and keratinized, skin texture thickened and hypertrophic, pigmentation, dark brown, scattered obvious scratch marks and blood crusts, pulse wiry and slippery, tongue coating white and greasy, tongue body red. Differentiation: Damp-toxin accumulated internally, manifesting on skin (Western diagnosis: Generalized eczema). Therapeutic method: Eliminate dampness, moisten skin, detoxify, and relieve itching. Prescription: Whole Scorpion 9g, Dictamnus Root Bark 45g, Kochia Fruit 30g, Toosendan Fruit 9g, Dry Rehmannia Root 30g, Silver Vine Stem 15g, Sophora Flower 30g, Xanthium Fruit 9g, Sophora Root Bark 15g, Tangerine Peel 6g. External: Gentian Root 90g, Siegesbeckia Herb 30g, Sichuan Pepper 9g. Decoct in water, wash externally. April 3, after taking three doses, itching slightly relieved. No other improvement, changed to clearing heat and eliminating dampness method, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) modified: Gentian Root 15g, Rhubarb 12g, Phellodendron Bark 12g, Scutellaria Root 12g, Toosendan Fruit 30g, Raw Atractylodes Macrocephala 15g, Red Poria Peel 15g, Dictamnus Root Bark 60g, Dry Rehmannia Root 30g, Raw Sophora Flower 30g, Xanthium Fruit 9g. External: Big Maple Seed Oil 2 bottles, Ruyi Jinhuang San (Ruyi Golden Yellow Powder) 4 bags, applied externally. Before May 5, took over 10 doses, little change, changed to Qinjiao Wan (Magnolia Berry Pill) formula modified: Magnolia Berry 15g, Black Snake 9g, Saposhnikovia Root 9g, Astragalus Root 15g, Sophora Root Bark 15g, Rhapontic Rhizome 9g, Coptis Rhizome 6g, Dictamnus Root Bark 30g, Silver Vine Stem 30g. Continuously took over 20 doses, significant improvement, skin lesion surface thinned and softened, itching basically disappeared. Later changed to taking Qinjiao Wan for over half a month, mid-June follow-up, whole body skin returned to normal, itching stopped, recent clinical cure. (Clinical Experience Collection of Zhao Bingnan)
Case 3 Zhu XX, female, 32 years old, medical record number: 129809, first visit date: January 3, 1967. For one month, facial skin flushed and infiltrated, with fine thin scales. Pulse wiry and fine, tongue pale, coating thinly distributed. Differentiation: Mian You Feng (Facial Wandering Wind), wind-dryness injuring blood (Western diagnosis: Seborrheic eczema). Therapeutic method: Nourish blood and dispel wind. Prescription: Raw and Prepared Rehmannia Root each 9g, Salvia Root 9g, Schizonepeta Spike 9g, Sophora Root Bark 9g, Dictamnus Root Bark 9g, Loquat Leaf 9g, Mulberry Root Bark 9g, Honeysuckle Stem 9g, Raw Licorice Root 6g, five doses. External: Qingbai San (Green-White Powder) mixed with sesame oil for application. January 9 (Second visit): After medication, facial scaling reduced, itching significantly alleviated, but new maculopapular rashes appeared on both forearms, lower back pain recently, difficulty turning. Still follow previous prescription, remove Honeysuckle Stem, add Eucommia Bark 9g, Dogspine 9g, take another 5 doses, basically cured. Qingbai San: Indigo Naturalis 30g, Cuttlefish Bone Powder 90g, Calcined Gypsum Powder 370g, Borneol 3g, first grind Indigo Naturalis finely, then add Cuttlefish Bone Powder and grind together, then add Calcined Gypsum Powder and grind together; put Borneol in mortar and gently grind finely, add a little of the above medicine and grind, then add all medicine powder and grind together. (Clinical Experience Collection of Zhu Renkang)
[Commentary] Eczema is mostly caused by wind-damp-heat pathogens lodging in the skin. Long-standing illness easily consumes blood, generating wind and dryness. Wind-dryness stagnation causes skin loss of nourishment, leading to chronic发作 of eczema. Case 1 was acute eczema, differentiated as damp-heat accumulated for a long time transforming into heat, with heat heavier than dampness, so treated with clearing heat, cooling blood, and promoting diuresis to eliminate dampness, later supplemented with liver-cooling agents. Syndrome and prescription were fitting. Case 2 was chronic secondary eczema, severe itching for 6 years, initially differentiated as damp-toxin accumulated internally, treated mainly with clearing and transforming damp-toxin, supplemented with nourishing ying and unblocking collaterals. Longdan Xiegan Tang was once ineffective, later treated mainly with dispelling wind and unblocking collaterals, clearing and transforming damp-heat as auxiliary, using Qinjiao Wan (Formula from Zhengzhi Zhunsheng) modified with efficacy. This case changed prescriptions three times. With diffuse involvement and severe itching of skin lesions, it indicated that pathogen stagnating in the exterior not dispersing was the main contradiction, damp-toxin was the secondary contradiction, so changed to Qinjiao Wan modified. Case 3 was seborrheic eczema, occurring on the face, named "Mian You Feng" in TCM, syndrome belonging to wind-dryness injuring blood. Treated with nourishing blood, moistening dryness, dispelling wind, and relieving itching, the prescription was quite appropriate. External application of Qingbai San has effects of absorbing dampness, relieving itching, reducing inflammation, and subsiding swelling. Besides treating eczema, it can also be used for allergic dermatitis.
(32) Neurodermatitis Du XX, female, 39 years old, worker, medical record number: 217683. First visit date: August 24, 1967. Generalized skin lichenification for two years. Over the past two years, patches of skin lichenification successively appeared on the posterior neck, extensor sides of elbows, lower limbs, etc., with unbearable itching, lighter during day and heavier at night, difficult to sleep, repeatedly treated without effect. Skin examination: Posterior neck, bilateral elbow extensor sides, anterior chest, lower limbs, etc., had relatively symmetrical, patchy, mildly lichenified lesions, pale red, numerous scratch marks, blood crusts formed, slight weeping. Pulse wiry and fine, coating yellow and greasy. Differentiation: Feng Xuan (Wind Lichenification), excess blood-heat internally, wind predominance transforming into dryness (Western diagnosis: Generalized neurodermatitis). Therapeutic method: Cool blood, clear heat, dispel wind, and relieve itching. Prescription: Pi Xuan Tang (Experience Formula) modified. Rehmannia Root 15g, Salvia Root 9g, Red Peony Root 9g, Schizonepeta Spike 9g, Saposhnikovia Root 6g, Rubia Root 9g, Malian (Coptis) 9g, Scutellaria Root 9g, Xanthium Fruit 9g, Dictamnus Root Bark 9g, Kochia Fruit 9g, decoct in water and take orally, 2 doses daily, divided into two servings. August 31