须用提其湿在下之药,随气血用。入方∶生地黄、酒洗黄柏、酒炒苍术、盐炒黄连、白术、防己、槟榔、川芎、
木通、陈皮、甘草梢、犀角屑。有热加芩连;有痰加竹沥、姜汁;大热及时令暑热,加石膏;大便实难者,加桃仁;小
便涩者,加杜牛膝。有食积流注用苍术、黄柏、汉防己、南星、川芎、白芷、犀角、槟榔,上末为丸。血虚加牛膝、
败龟板,曲糊丸。如常肿者,专主乎湿热,朱先生另有方。有香港脚冲心者,乃血虚而有火气上行,宜四物汤加炒
黄柏,再于涌泉穴用附子为末,津拌如小钱大,贴之,以艾火灸,泄引其热。转筋皆属血热,左金丸降肝火。香港脚
肿者,枳实、大黄、当归、羌活。肢节烦疼,肩背沉重,胸膈不利,及遍身疼痛下注于足胫肿痛,当归拈痛汤。诸
湿客于腰膝重痛,足胫浮肿,除湿丹∶乳香 没药(以上各一两研) 牵牛头末(半两) 槟榔 威灵仙 赤芍药 泽
泻葶苈 甘遂(以上各二两) 大戟(三两) 陈皮(六两去白) 上末之,糊丸。香港脚从湿从下,以治湿治气,紫
苏、炒柏、芍药、木瓜、泽泻、木通、防己、槟榔、苍术、枳壳、甘草、香附、羌活。痛多加木香;肿多加大腹皮;发
热加黄连。脚弱筋痛∶牛膝(二两) 白芍(一两半) 酒柏 知母 甘草(炒各五钱),酒糊丸服。
湿痰香港脚,大便滑泄∶苍术(二两) 防风 槟榔 滑石(各一两) 香附(八钱) 川芎(六钱) 条芩 木通(各
四钱) 甘草(三钱) 或丸或散皆可。健步丸方∶生地(一两半) 归尾 陈皮 芍药 牛膝
苍、白术(各一两) 茱萸 条芩(各五钱) 大腹子(三钱) 桂枝(二钱) 为末作丸,每服百丸,通草汤食前下。
一妇人足痛肿者,生地、炒柏、南星、芎、苍、牛膝、龙胆、红花酒洗。一
人筋动于足大指,渐渐上□□□至近腰结了,奉养浓,因饮□□□湿热伤血,四物加黄芩、红花□□。一男子年近三
十,浓味多怒,□□□髀枢左右发痛一点,□静□□□处恶寒,或渴或不渴,膈或□□□风药无血补药至次春膝□□
□甚食减,形瘦至春末,膝肿□□□可屈伸,脉弦大颇实寸涩□□□皆数短,其小便数少,遂作□□□积在太阴阳明,
治之其详□□□条下。
必须使用将湿气从下部提升的药物,并根据气血状况灵活配伍。入方药物包括:生地黄、酒洗黄柏、酒炒苍术、盐炒黄连、白术、防己、槟榔、川芎、木通、陈皮、甘草梢、犀角屑。若有热象,加黄芩、黄连;有痰饮,加竹沥、姜汁;大热或正值时令暑热,加石膏;大便干结难下者,加桃仁;小便涩滞不畅者,加杜牛膝(怀牛膝)。若因食积流注所致,用苍术、黄柏、汉防己、天南星、川芎、白芷、犀角、槟榔,研末制成丸剂。血虚者加牛膝、败龟板,用曲糊为丸。如常表现为肿胀者,主要病机在于湿热,朱先生另有专门方剂。若有香港脚(足部肿痛之疾)冲心者,乃血虚而有火气上行,宜用四物汤加炒黄柏,再于涌泉穴用附子研末,以唾液调拌如小铜钱大小贴敷,并用艾火灸治,以泄引其热。转筋(肌肉痉挛)皆属血热,可用左金丸以降肝火。香港脚肿胀者,用枳实、大黄、当归、羌活治疗。肢体关节烦痛,肩背沉重,胸膈痞闷不利,以及遍身疼痛下行注于足胫导致肿痛者,用当归拈痛汤。各种湿邪客居于腰膝导致重痛,足胫浮肿者,用除湿丹:乳香、没药(以上各一两研细)、牵牛头末(半两)、槟榔、威灵仙、赤芍药、泽泻、葶苈子、甘遂(以上各二两)、大戟(三两)、陈皮(六两去白),研末,用糊为丸。香港脚病因多从湿起,病位在下,以治湿、治气为主,药用紫苏、炒黄柏、芍药、木瓜、泽泻、木通、防己、槟榔、苍术、枳壳、甘草、香附、羌活。疼痛多加木香;肿胀多加大腹皮;发热加黄连。脚弱筋痛:牛膝(二两)、白芍(一两半)、酒黄柏、知母、甘草(炒各五钱),酒糊为丸服用。湿痰型香港脚,伴有大便滑泄者:苍术(二两)、防风、槟榔、滑石(各一两)、香附(八钱)、川芎(六钱)、条芩、木通(各四钱)、甘草(三钱),可制成丸剂或散剂。健步丸方:生地(一两半)、归尾、陈皮、芍药、牛膝、苍术、白术(各一两)、茱萸、条芩(各五钱)、大腹子(三钱)、桂枝(二钱),研末作丸,每次服一百丸,饭前用通草汤送下。一位妇人足部疼痛肿胀,用生地、炒黄柏、南星、川芎、苍术、牛膝、龙胆草、红花(酒洗)。一人足大指筋脉跳动,渐渐向上蔓延至腰部结聚处,因生活优渥饮食厚味,因饮酒损伤湿热伤血,用四物汤加黄芩、红花。一男子年近三十,饮食厚味且多怒,大腿枢轴左右某一点发痛,静止时局部恶寒,有时口渴有时不渴,膈间或有不适,风药无补血药,到了次年春季膝盖症状加重,食欲减退,形体消瘦至春末,膝盖肿胀僵硬不可屈伸,脉象弦大颇实,寸脉涩,其余脉皆数短,其小便频而量少,遂辨为食积在太阴、阳明经,治疗详情见相关条目下。
It is necessary to use herbs that lift dampness from the lower part, combined flexibly according to Qi and Blood conditions. The prescription includes: Shengdi Huang (Rehmanniae Radix), Huang Bo (Phellodendri Cortex) washed with wine, Cang Zhu (Atractylodis Rhizoma) fried with wine, Huang Lian (Coptidis Rhizoma) fried with salt, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix), Bing Lang (Arecae Semen), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Mu Tong (Akebiae Caulis), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao Gao (Glycyrrhizae Radix et Rhizoma tip), Xi Jiao Xie (Rhinocerotis Cornu). If there is heat, add Huang Qin (Scutellariae Radix) and Huang Lian; if there is phlegm, add Zhu Li (Bambusae Sap) and Jiang Zhi (Zingiberis Recens Juice); for severe heat or seasonal summer-heat, add Shi Gao (Gypsum Fibrosum); for dry and difficult stool, add Tao Ren (Persicae Semen); for astringent and difficult urination, add Du Niu Xi (Achyranthis Bidentatae Radix). For cases caused by food stagnation flowing into collaterals, use Cang Zhu, Huang Bo, Han Fang Ji (Stephaniae Sinensis Radix), Nan Xing (Arisaematis Rhizoma), Chuan Xiong, Bai Zhi (Angelicae Dahuricae Radix), Xi Jiao, Bing Lang, grind into powder, and make pills. For Blood deficiency, add Niu Xi (Achyranthis Bidentatae Radix) and Bai Gui Ban (Testudinis Carapax et Plastrum dried), made into pills with Qu paste. If swelling is common, the main pathogenesis is Damp-Heat; Master Zhu has another specific formula. For Hong Jiao Jiao (Gout/Feet Swelling Disease) rushing to the heart, it is due to Blood deficiency with Fire qi ascending; Si Wu Tang (Four Substances Decoction) with fried Huang Bo should be used. Additionally, Fu Zi (Aconiti Lateralis Radix Praeparata) powder mixed with saliva to the size of a small coin should be applied to Yong Quan (KI1) acupoint and moxa-moxibusted to drain and guide the heat downwards. Muscle spasms (Zhuan Jin) all belong to Blood Heat; Zuo Jin Wan (Left Metal Pill) descends Liver Fire. For Hong Jiao Jiao swelling, use Zhi Shi (Aurantii Fructus Immaturus), Da Huang (Rhei Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Qiang Huo (Notopterygii Rhizoma et Radix). For painful joints, heavy shoulders and back, chest diaphragm discomfort, and body-wide pain descending to cause swelling and pain in the shins, use Dang Gui Nian Tong Tang (Danggui Analgesic Decoction). For various Damp pathogens lodging in waist and knees causing heaviness and pain, and swollen shins, use Chu Shi Dan (Dampness-Removing Elixir): Ru Xiang (Olibanum), Mo Yao (Myrrha) (each 1 liang, ground), Qian Niu Tou Mo (Semen Pharbitidis head end powder) (0.5 liang), Bing Lang, Wei Ling Xian (Clematidis Radix et Rhizoma), Chi Shao Yao (Paeoniae Radix Rubra), Ze Xie (Alismatis Rhizoma), Ting Li (Semen Lepidii et Descurainiae), Gan Sui (Kansui Radix) (each 2 liang), Da Ji (Euphorbiae Pekinensis Radix) (3 liang), Chen Pi (6 liang, white part removed), grind into powder, make pills with paste. Hong Jiao Jiao originates from Dampness and affects the lower part; treatment focuses on resolving Dampness and regulating Qi, using Zi Su (Perillae Folium), fried Bai Bo (Phellodendri Cortex), Shao Yao (Paeoniae Radix), Mu Gua (Chaenomelis Fructus), Ze Xie, Mu Tong, Fang Ji, Bing Lang, Cang Zhu, Zhi Ke (Aurantii Fructus), Gan Cao, Xiang Fu (Cyperi Rhizoma), Qiang Huo. Add Mu Xiang (Aucklandiae Radix) for more pain; add Da Fu Pi (Arecae Pericarpium) for more swelling; add Huang Lian for fever. For weak feet and painful tendons: Niu Xi (2 liang), Bai Shao (Paeoniae Radix Alba) (1.5 liang), Jiu Bai (Wine-fried Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), Gan Cao (fried each 5 qian), make pills with wine paste. For Damp-Phlegm Hong Jiao Jiao with loose stools: Cang Zhu (2 liang), Fang Feng (Saposhnikoviae Radix), Bing Lang, Hua Shi (Talcum) (each 1 liang), Xiang Fu (8 qian), Chuan Xiong (6 qian), Tiao Qin (Scutellariae Radix), Mu Tong (each 4 qian), Gan Cao (3 qian), can be made into pills or powder. Jian Bu Wan (Leg-Strengthening Pill): Sheng Di (1.5 liang), Gui Wei (Angelicae Sinensis Radix tail), Chen Pi, Shao Yao, Niu Xi, Cang Zhu, Bai Zhu (each 1 liang), Zhu Yu (Corni Fructus), Tiao Qin (each 5 qian), Da Fu Zi (Arecae Pericarpium) (3 qian), Gui Zhi (Cinnamomi Ramulus) (2 qian), grind into powder, make pills, take 100 pills per dose before meals with Tong Cao (Tetrapanacis Medulla) decoction. A woman with painful and swollen feet was treated with Sheng Di, fried Huang Bo, Nan Xing, Chuan Xiong, Cang Zhu, Niu Xi, Long Dan Cao (Gentianae Radix), Hong Hua (Carthami Flos) washed with wine. A man had tendon movement in the big toe gradually spreading upwards to the waist area, due to rich diet and alcohol damaging Damp-Heat and Blood, treated with Si Wu Tang plus Huang Qin and Hong Hua. A man near thirty years old, with rich diet and frequent anger, had pain at one point around the hip joint, chills when still, sometimes thirsty sometimes not, diaphragmatic discomfort, wind herbs without blood tonics, symptoms worsened in spring with reduced appetite, emaciation by late spring, knee swelling and stiffness preventing flexion and extension, pulse wiry and large but solid, cun position choppy, other pulses rapid and short, frequent but scanty urination, diagnosed as Food Stagnation in Tai Yin and Yang Ming meridians; detailed treatment is under relevant entries.