足阳明经有蕴热。口中因之有秽息。倘或臭气不可闻。纵是神仙医不得。
口气秽浊。乃热邪蕴积于胃。宜用清金降火之剂为急。以清胃散、少用升麻。以开提胃气。加
连翘、牛蒡子治之。如麻收之后。有口臭、口疮、唇烂。兼之咽喉疼痛者。以生地败毒散。除去赤
芍、桔梗、甘草、柴胡。加黄连治之。其有口臭不可闻者。此是胃烂。必死之症。若其人原有口臭
者。则不在此例。当详问施治。
朱曰 口臭一证。有自少至老不愈者。惟麻时口臭。不可不注意。
清胃散 症治与六十二条加味清胃散同。
生地黄(四钱) 当归 黄连(酒蒸各三钱) 升麻(一钱五分) 丹皮(五钱) 石膏引。
生地败毒散
生地黄(一钱五分) 丹皮 黄芩(酒炒) 柴胡(各七分) 牛蒡子(炒) 连翘 天花粉 元参 金银花
桔梗(各八分) 薄荷叶 黄柏 赤芍(各五分) 生甘草(去皮三分) 熟石膏 淡竹叶(各一钱) 灯心五十
寸引。水煎。另以犀角磨汁对服。
心脾胃经毒未降。热壅上焦口生疮。满口唇舌俱赤烂。独有牙龈不受伤。
口疮之症。满口唇舌生疮。或黄、或赤、或白、而烂。独牙龈无恙者、即是也。其症多见于正收
及收后。乃心脾胃三经火甚。余热未尽。而毒壅上焦。下必大便燥结。小便赤涩。治宜清利心脾之
火。兼润大肠之剂。以导赤散(见二十五条)去甘草。加猪苓、泽泻。以导脾胃之火。火麻仁、杏仁、
以润大肠之燥。若得大便通利。小便频行。其毒自退。外以绿袍散吹之。如乳下婴儿。乳母有热。
亦当服药。使乳无热。儿亦清安。以 乳方、去甘草、与乳母服之。若麻收之后。口疮唇裂者。均宜
以秘本洗心散去麻黄、或以河间凉膈散(见二十六条)去芒硝、甘草。俱加石膏、牛蒡子下之。如
系牙疳之症。则又从牙疳门施治。
绿袍散 治一切口疮腐烂。(朱曰 绿袍散治口疮神效。)
荆芥穗 薄荷叶 青黛(各三钱) 元明粉 硼砂(各二钱) 百药煎(二钱五分) 甘草
(一钱五分) 为末。点舌上。令其自化。或用新汲井水。和蜜、调点舌上。亦可。
乳方
木通 泽泻 猪苓 生地黄 赤茯苓 天花粉 连翘 黄芩 西茵陈 甘草梢 灯心
引。水煎。
上药、候乳母食后。令捏去宿乳服之。服后。令乳母仰卧。使药味传贯于乳。再令乳母略去乳
汁少许。然后以乳哺儿。仍以此药与儿同服。
秘本洗心散 专治口舌生疮。
当归 生地黄 木通 黄连 大黄 薄荷叶 麻黄茸 各等分。灯心引。水煎服。
足阳明胃经蕴藏热邪,因此口中产生秽浊之气。如果臭气令人难以忍受,即使是神仙也难以医治。
口气秽浊,是由于热邪积聚在胃中。应当紧急使用清金降火的方剂。以清胃散为基础,少用升麻,以升提胃气;加入连翘、牛蒡子来治疗。如果在麻疹消退之后,出现口臭、口疮、嘴唇溃烂,并伴有咽喉疼痛的症状,使用生地败毒散,去掉其中的赤芍、桔梗、甘草、柴胡,加入黄连进行治疗。如果有口臭严重到不可闻的程度,这是胃腑腐烂的表现,属于必死的病症。但是如果患者原本就有口臭的情况,则不在此列,应当详细询问病情后施治。
朱氏说:口臭这一症状,有从年少到年老一直不愈的。只有在出麻疹期间出现的口臭,才需要特别注意。
清胃散:其症治方法与第六十二条中的加味清胃散相同。
组成:生地黄(四钱)、当归、黄连(酒蒸,各三钱)、升麻(一钱五分)、丹皮(五钱),以石膏为引。
生地败毒散
组成:生地黄(一钱五分)、丹皮、黄芩(酒炒)、柴胡(各七分)、牛蒡子(炒)、连翘、天花粉、元参、金银花、桔梗(各八分)、薄荷叶、黄柏、赤芍(各五分)、生甘草(去皮三分)、熟石膏、淡竹叶(各一钱),以灯心草五十寸为引。水煎服。另外磨犀角汁兑入服用。
心、脾、胃三经的毒邪未能下降,热邪壅塞在上焦,导致口中生疮。满口的嘴唇和舌头都发红溃烂,唯独牙龈没有受伤。
口疮的症状是满口嘴唇和舌头生疮,颜色或黄、或赤、或白,并且溃烂,唯独牙龈完好无损的,就是这种病。这种症状多见于麻疹正收及收后阶段,是由于心、脾、胃三经火气旺盛,余热未尽,毒邪壅塞在上焦。下部必然出现大便燥结、小便赤涩的症状。治疗应当清利心脾之火,兼用润肠通便的方剂。使用导赤散(见第二十五条)去掉甘草,加入猪苓、泽泻,以引导脾胃之火下行;用火麻仁、杏仁,以润大肠之燥。如果能使大便通畅,小便频行,毒邪自然消退。外用绿袍散吹敷患处。如果是吃奶的婴儿,乳母有热,也应当让乳母服药,使乳汁无热,婴儿也能清凉安适。使用 乳方,去掉甘草,给乳母服用。如果在麻疹消退之后,出现口疮、嘴唇干裂的情况,都适宜使用秘本洗心散,去掉麻黄;或者使用河间凉膈散(见第二十六条),去掉芒硝、甘草,均加入石膏、牛蒡子攻下。如果是牙疳的症状,则应从牙疳门进行施治。
绿袍散:治疗一切口疮腐烂。(朱氏说:绿袍散治疗口疮神效。)
组成:荆芥穗、薄荷叶、青黛(各三钱)、元明粉、硼砂(各二钱)、百药煎(二钱五分)、甘草(一钱五分)。研为细末,点涂在舌上,令其自然融化。或者用新打的井水,调和蜂蜜,点涂在舌上,也可以。
乳方
组成:木通、泽泻、猪苓、生地黄、赤茯苓、天花粉、连翘、黄芩、西茵陈、甘草梢、灯心草为引。水煎服。
上述药物,待乳母进食后,令其挤去宿乳后服用。服药后,令乳母仰卧,使药味传导至乳汁中。再令乳母挤出少许乳汁,然后用乳汁哺育婴儿。同时将此药也给婴儿同服。
The Foot-Yangming Stomach Meridian harbors accumulated heat, thereby causing foul breath. If the odor is unbearable, even a divine physician cannot cure it.
Foul breath results from heat pathogens accumulating in the Stomach. It is urgent to use formulas that clear Metal and descend Fire. Use Qingwei San (Stomach-Clearing Powder) with a small amount of Shengma (Cimicifugae Rhizoma) to raise and lift Stomach Qi, adding Qiaqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus) for treatment. After the resolution of Measles (Ma), if there are symptoms of bad breath, mouth sores (Kouchuang), lip ulceration, accompanied by sore throat, use Shengdi Baidu San (Rehmannia Detoxification Powder). Remove Chishao (Paeoniae Radix Rubra), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), and Chaihu (Bupleuri Radix), and add Huanglian (Coptidis Rhizoma). If the bad breath is intolerable, this indicates rotting of the Stomach, a fatal condition. However, if the person originally had bad breath, this case does not fall under this category; one should inquire in detail before treating.
Zhu stated: Regarding the symptom of bad breath, some suffer from it from youth to old age without relief. Only bad breath occurring during Measles requires careful attention.
Qingwei San (Stomach-Clearing Powder): The syndrome treatment is the same as the Modified Qingwei San described in Article 62.
Ingredients: Shengdihuang (Rehmanniae Radix Preparata, 4 qian), Danggui (Angelicae Sinensis Radix), Huanglian (Coptidis Rhizoma, wine-steamed, each 3 qian), Shengma (Cimicifugae Rhizoma, 1.5 qian), Danpi (Moutan Cortex, 5 qian), with Shigao (Gypsum Fibrosum) as an guiding agent.
Shengdi Baidu San (Rehmannia Detoxification Powder)
Ingredients: Shengdihuang (Rehmanniae Radix Preparata, 1.5 qian), Danpi (Moutan Cortex), Huangqin (Scutellariae Radix, wine-fried), Chaihu (Bupleuri Radix, each 0.7 qian), Niubangzi (Arctii Fructus, stir-fried), Qiaqiao (Forsythiae Fructus), Tianhuafen (Trichosanthis Radix), Yuan Shen (Scrophulariae Radix), Jinyinhua (Lonicerae Japonicae Flos), Jiegeng (Platycodonis Radix, each 0.8 qian), Boheye (Menthae Haplocalycis Herba), Huangbai (Phellodendri Cortex), Chishao (Paeoniae Radix Rubra, each 0.5 qian), Sheng Gancao (Glycyrrhizae Radix et Rhizoma, peeled, 0.3 qian), Shu Shigao (Prepared Gypsum Fibrosum), Danzhuye (Lophatheri Herba, each 1 qian), with Dengxincao (Junci Medulla, 50 cun) as a guiding agent. Decoct in water. Additionally, grind Xijiao (Rhinocerotis Cornu) into juice and mix for administration.
Toxicity from the Heart, Spleen, and Stomach meridians fails to descend; heat obstructs the Upper Jiao, causing sores in the mouth. The lips and tongue throughout the mouth become red and ulcerated, while the gums remain unaffected.
The symptom of Kouchuang (Mouth Sores) involves sores on the lips and tongue throughout the mouth, which may be yellow, red, or white, and ulcerated, while the gums remain healthy. This syndrome is common during the consolidation and post-consolidation stages of Measles. It arises from excessive fire in the Heart, Spleen, and Stomach meridians, with residual heat lingering and toxicity obstructing the Upper Jiao. Consequently, there must be dry stool constipation and dark, scanty urine. Treatment should clear and drain the fire of the Heart and Spleen, combined with moistening agents for the Large Intestine. Use Daochi San (Guide Out Red Powder - see Article 25), remove Gancao (Glycyrrhizae Radix et Rhizoma), and add Zhuling (Polyporus), Zexie (Alismatis Rhizoma) to guide the fire of the Spleen and Stomach downward; use Huomaren (Ricini Semen) and Xingren (Armeniacae Semen Amarum) to moisten the dryness of the Large Intestine. If bowel movements become smooth and urination frequent, the toxicity will naturally recede. Externally, apply Lvpaos San (Green Robe Powder) as a dusting powder. For nursing infants, if the mother has heat, she should also take medicine to ensure her milk is free of heat, keeping the infant cool and safe. Use Ru Fang (Nursing Formula), remove Gancao (Glycyrrhizae Radix et Rhizoma), and administer to the mother. If after the resolution of Measles, mouth sores and cracked lips occur, both conditions are suitable for treatment with Miben Xixin San (Secret Standard Heart-Washing Powder), removing Mahuang (Ephedrae Herba); or use Hejian Liange San (He Jian's Cooling Honeycomb Powder - see Article 26), removing Mangxiao (Natrii Sulfas) and Gancao (Glycyrrhizae Radix et Rhizoma), all added with Shigao (Gypsum Fibrosum) and Niubangzi (Arctii Fructus) to purge downward. If it is a case of Yagan (Gum Gangrene), treat according to the Yagan section.
Lvpaos San (Green Robe Powder): Treats all types of mouth sores and ulceration. (Zhu stated: Green Robe Powder is miraculous for treating mouth sores.)
Ingredients: Jingjiesui (Schizonepetae Spica), Boheye (Menthae Haplocalycis Herba), Qingdai (Indigo Naturalis, each 3 qian), Yuanmingfen (Mirabilite), Pengsha (Borax, each 2 qian), Baiyaojian (Myrobalan Pill, 2.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1.5 qian). Grind into powder. Apply to the tongue, allowing it to dissolve naturally. Alternatively, use fresh well water mixed with honey to apply to the tongue.
Ru Fang (Nursing Formula)
Ingredients: Mutong (Akebiae Caulis), Zexie (Alismatis Rhizoma), Zhuling (Polyporus), Shengdihuang (Rehmanniae Radix), Chi Fuling (Poria with Red Core), Tianhuafen (Trichosanthis Radix), Qiaqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Xi Yinchen (Artemisiae Scopariae Herba), Gancao Shao (Tip of Glycyrrhizae Radix et Rhizoma), Dengxincao (Junci Medulla) as a guiding agent. Decoct in water.
Administer the above medicines to the nursing mother after meals. Have her express and discard old milk before taking the medicine. After ingestion, have the mother lie supine to allow the medicinal properties to transmit into the milk. Then, have her express and discard a small amount of milk before breastfeeding the infant. Administer this medicine to the infant simultaneously.
Miben Xixin San (Secret Standard Heart-Washing Powder): Specifically treats sores in the mouth and tongue.
Ingredients: Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Mutong (Akebiae Caulis), Huanglian (Coptidis Rhizoma), Dahuang (Rhei Radix et Rhizoma), Boheye (Menthae Haplocalycis Herba), Mahuang Rong (Young Sprouts of Ephedrae Herba), in equal proportions. Use Dengxincao (Junci Medulla) as a guiding agent. Decoct in water and take orally.