膝头独大鹤同形，三气（风、寒、湿）温因脚部停，五积服完白芥敷，十全（大补汤）加味妙温
经。
香港脚之源，考之《经》曰∶“暑胜则地热，风胜则地动，湿胜则地泥，寒胜则地裂，寒
暑风湿之气虽本乎天，而皆入乎地，而人之足履之所以往往受其毒也。”如从足起，渐入小
腹，甚乃上攻心胸，若不急治，遂至杀人，盖以五脏经络，脾与肝肾，皆从足指上走腹中故
也。然其证则有干、湿之不同∶湿香港脚者，两脚肿大，或下注生疮，浸淫滋水，宜鸡鸣散；
干香港脚者，两胫不肿，或顽麻，或挛急，或纵缓为血虚，而兼湿热，宜四物汤加牛膝、独活
、苍术、泽泻，热者加黄柏、知母、茵陈。寒者加干姜、附子、吴茱萸、肉桂之类。二症俱
名壅疾，不可骤补。若上气喘急，及上小腹不仁，恐攻心不救，《金匮》用肾气丸。此症因
形肿在外，故列于表症。
脚肿原因湿气来，鸡鸣散剂勿徘徊，（干香港脚症，不肿而顽麻拘急）宜四物加苍泽，肾气
丸平逆上灾。
暑症口渴，心烦，溺赤，身热，脉洪而虚，轻者为伤暑，以六一散荡涤热气，从小便而
泄。若暑热闭郁而无汗，必用香苏饮，发越阳气，彻上彻下，解表兼利小便而愈。重者名为
中暑，大渴大汗，宜白虎汤加人参主之。或汗出身热，而两足冷者，是暑而挟湿，宜白虎加
苍术汤主之。若中暑昏闷不醒，并伏暑停食吐泻，宜半夏四钱，茯苓、甘草各二钱，研末，
入生姜汁少许，开水调灌之。后夏月贪凉，多伤寒之病，宜用伤寒法治之，且暑月伏阴在内
，吐泻证可用理中汤者，十之六、七，甚者必用通脉四逆汤，若吐泻而渴，宜五苓散。
（经义）《刺志论》曰∶“气虚身热，得之伤暑。”《生气通天论》曰∶“因于暑，汗，烦
则喘满，静则多言，体若燔炭，汗出而散。”仲景云∶“脉虚身热，得之伤暑”。
膝盖部位单独肿大，形状如同鹤膝，这是因为风、寒、湿三气停留在脚部所致。服用完五积散后，再外敷白芥子，使用加味的十全大补汤效果奇妙，能温通经络。
香港脚（脚气病）的源头，考证《内经》说：“暑气胜则地面炎热，风气胜则地面震动，湿气胜则地面泥泞，寒气胜则地面开裂。”寒、暑、风、湿之气虽然本源于天，但都进入地下，而人的脚踩踏在地上，所以往往受到这些邪气的毒害。如果病症从足部开始，逐渐侵入小腹，严重时甚至向上攻冲心胸，如果不紧急治疗，会导致死亡，这是因为五脏经络中，脾与肝、肾的经脉，都是从足趾向上行走至腹中的缘故。然而其证候则有干性、湿性的不同：湿性香港脚，表现为两脚肿大，或者向下流注生疮，浸淫流水，适宜用鸡鸣散；干性香港脚，表现为两小腿不肿，或者麻木不仁，或者拘挛紧急，或者弛缓无力属于血虚，兼夹湿热，适宜用四物汤加牛膝、独活、苍术、泽泻，热象明显的加黄柏、知母、茵陈；寒象明显的加干姜、附子、吴茱萸、肉桂之类。这两种证候都称为壅塞之疾，不可骤然进补。如果出现上气喘急，以及小腹感觉迟钝麻木，恐怕邪气攻心无法救治，《金匮要略》主张用肾气丸。此症因为外形肿胀在外，所以列在表症之中。
脚肿的原因是湿气来袭，鸡鸣散剂不要犹豫迟疑。（对于干性香港脚症，不肿而是麻木拘急），适宜用四物汤加苍术、泽泻，肾气丸可以平定逆上的灾祸。
暑症出现口渴、心烦、小便赤红、身体发热、脉象洪大而虚，轻者称为伤暑，用六一散荡涤热气，从小便排出。如果暑热闭郁而无汗，必须用香苏饮，发散阳气，彻上彻下，解表兼利小便而痊愈。重者名为中暑，大渴大汗，适宜用白虎汤加人参主治。或者出汗后身体发热，而两脚发冷的，是暑邪挟带湿气，适宜用白虎加苍术汤主治。如果中暑昏迷不醒，以及伏暑停食导致的吐泻，适宜用半夏四钱，茯苓、甘草各二钱，研成末，加入少许生姜汁，开水调匀灌服。之后夏天月份贪凉，多患伤寒病，适宜用治疗伤寒的方法处理，而且暑月体内潜伏阴寒，吐泻证候可用理中汤的，占十分之六、七，严重的必须用通脉四逆汤，如果吐泻且口渴，适宜用五苓散。
（经文义理）《刺志论》说：“气虚身体发热，得自伤暑。”《生气通天论》说：“因于暑邪，出汗，烦躁则喘满，安静则多言，身体像燃烧的炭火一样热，出汗后热散。”张仲景说：“脉虚身体发热，得自伤暑”。
The knee joint swells alone, resembling the shape of a crane's knee; this is caused by the Wind, Cold, and Dampness (Feng, Han, Shi) stagnating in the lower limbs. After completing the administration of Wuji San (Five Accumulations Powder), applying White Mustard Seed (Baijiezi) externally, and using modified Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) yields excellent results, effectively warming and unblocking the meridians.
The origin of Hongxiangjiao (Foot Qi / Beriberi) can be traced to the *Neijing* (Classic of Internal Canon), which states: "When Heat dominates, the earth becomes hot; when Wind dominates, the earth shakes; when Dampness dominates, the earth becomes muddy; when Cold dominates, the earth cracks." Although the Qi of Cold, Heat, Wind, and Dampness originates from Heaven, it enters into the Earth. Consequently, human feet tread upon the ground and often suffer from their toxicity. If the condition starts from the feet and gradually invades the lower abdomen, and severely attacks the chest and heart, failure to treat it urgently will lead to death. This is because the meridians of the Zang organs—specifically the Spleen, Liver, and Kidney—ascend from the toes to the abdomen. However, the manifestations differ between Dry and Wet types: In Wet Hongxiangjiao, both feet swell, or sores form below with oozing fluid, requiring Jiming San (Crowing Rooster Powder). In Dry Hongxiangjiao, the calves do not swell but present with numbness, cramping, or flaccidity due to Blood deficiency combined with Damp-Heat; Siwu Tang (Four Substances Decoction) added with Niuxi (Achyranthes Root), Duhuo (Angelica Pubescens), Cangzhu (Atractylodes Rhizome), and Zexie (Alisma Rhizome) is indicated. For Heat patterns, add Huangbai (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), and Ychen (Artemisia Capillaris); for Cold patterns, add Ganjiang (Dried Ginger), Fuzi (Aconite Lateral Root), Wuzhuyu (Evodia Fruit), and Rougui (Cinnamon Bark). Both conditions are termed Yong Ji (Obstructive Diseases) and should not be tonified abruptly. If accompanied by wheezing and shortness of breath, or insensitivity in the lower abdomen, fearing cardiac attack, the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) recommends Shenqi Wan (Kidney Qi Pill). Since this condition presents with external swelling, it is categorized under Exterior Syndromes.
Swelling of the feet arises from Dampness; do not hesitate to use Jiming San. (For Dry Hongxiangjiao, characterized by numbness and cramping without swelling), Siwu Tang added with Cangzhu and Zexie is suitable, while Shenqi Wan can calm rebellious Qi and prevent disaster.
In Summerheat syndromes presenting with thirst, vexation, dark urine, fever, and a洪 (Surging) yet empty pulse, mild cases are termed Shangshu (Summerheat Injury). Liuyi San (Six-to-One Powder) is used to cleanse Heat Qi, excreting it via urination. If Summerheat is closed and depressed without sweating, Xiangsu Yin (Perilla and Eupatorium Drink) must be used to disperse Yang Qi, penetrating from top to bottom, resolving the exterior and promoting diuresis to achieve cure. Severe cases are named Zhongshu (Heat Stroke), characterized by extreme thirst and profuse sweating, treated primarily with Baihu Tang (White Tiger Decoction) plus Renshen (Ginseng Root). If sweating occurs followed by fever but cold feet, this indicates Summerheat complicated by Dampness, treated with Baihu Jia Cangzhu Tang (White Tiger Decoction plus Atractylodes). If heat stroke causes coma and unconsciousness, or if latent Summerheat with food stagnation leads to vomiting and diarrhea, use Banxia (Pinellia Tuber) 4 qian, Fuling (Poria) and Gancao (Licorice Root) 2 qian each, powdered, mixed with a little fresh ginger juice, and administered with boiled water. Later in summer, excessive cooling often leads to Cold Damage diseases, which should be treated according to Cold Damage protocols. Moreover, during summer months, Yin Cold lurks internally; for vomiting and diarrhea, Lizhong Tang (Regulate the Middle Decoction) is applicable in six or seven out of ten cases. Severe cases require Tongmai Sini Tang (Unblock the Pulse Four Reversal Decoction). If vomiting and diarrhea are accompanied by thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated.
(Interpretation of Classic Texts) The *Cizhi Lun* (Treatise on Acupuncture and Vitality) states: "Qi deficiency with body heat results from Summerheat injury." The *Shengqi Tongtian Lun* (Treatise on Vital Energy Connecting to Heaven) states: "Due to Summerheat, there is sweating; vexation leads to panting and fullness, while quietness leads to excessive talking; the body feels like burning charcoal, and heat dissipates with sweating." Zhang Zhongjing stated: "Empty pulse with body heat results from Summerheat injury."