论
《内经》曰∶诸湿肿满,皆属脾土。又曰∶伤于湿者,下先受之。盖脾主四肢,足居于下而多受其湿,湿郁成热,
湿热相搏,其病作矣。是以先从气冲穴隐核痛起,及两足胫红肿,或恶寒发热,状若伤寒,筋挛掣痛,是其候也。或一
旬,或半月,复作如故,渐渐而致于足筋肿大如瓜瓠者,多有之矣。东南卑湿之地,比比皆是;西北高燥之方,鲜或有
之。古方名为缓风,由宋元以来呼为香港脚。原其所由,非止一端,有从外感而得者,有从内伤而致者,所感虽有内外之
殊,其为湿热之患则一也。故异法方宜论云∶北方者,其地高陵居,风寒冰冽。俗饮 酪而肉食,皆以饮多速饮为能。
经曰∶因而大饮则气逆。夫乳酪醇酒者,湿热之物,饮之属也,加以奉养太过,又滋其湿,水性顺下,气不能 ,故下
注于足胫,积久而为肿满疼痛,此饮食下流之所致也。东南地势卑下,湿气迷满山泽,行履坐卧,无处不有。若禀壮而
气实者,不能侵贼;其气虚血少之人,或遇房劳,及负重远行,冲冒雨雪,寒湿乘虚而客袭于足,而成此证,是外感寒
湿之所致也。大抵病因有内外之殊,而治法无表里之异耳。故为治者,宣通用苍术、白术之类以治其湿,知母、黄柏、
条芩之类以去其热,当归、芍药、生地黄之类以调其血,木瓜、槟榔之类以行其气,羌活、独活以利关节而散风湿,兼
用木通、防己、川牛膝之类引药下行及消肿去湿,以为此证大法,不过如此。东垣曰∶湿淫所胜,治以苦温,以苦辛发
之,透关节胜湿为佐,以苦寒泄之。流湿清热为臣,故立当归拈痛汤以治之,其效捷如影响。针经曰∶有道以来,必有
道以去。治宜多以针灸为佳,以导引其湿热之气外出也。学人宜详究焉。
脉法
脉弦者风,濡弱者湿,洪数者热,迟涩者寒,微滑者虚,牢坚者实,结则因气,散则因忧,紧则因怒,细则因悲。
方法
丹溪曰∶香港脚从湿从下,须提起其湿,在下之药随气血用。入心则恍惚谬妄,呕吐,食不入,眠卧不安,左寸脉乍
大乍小或乍有乍无者死。入肾则腰脚肿,小便不通,呻吟,目与额皆黑,气冲胸而喘,左尺脉绝者死。
治湿热香港脚方
紫苏 黄柏(盐酒拌炒) 芍药 木瓜 泽泻(去毛) 木通(去皮) 防己 槟榔 苍术(米泔浸) 枳壳(麸
炒黄色) 甘草(炙) 香附(童便浸炒) 羌活(以上各等分)
痛加木香,肿甚加大腹皮,发热加黄连、大黄。
上细切,水煎服。痛除肿退则住服。
防己饮
黄柏(酒炒) 苍术(盐水炒 )白术 防己(各七分) 生地黄 槟榔 川芎(各五分) 犀角屑 甘草节 木
通黄连(各三分)
上细切,作一服,水一盏半,煎至一盏,去渣食前温服。有热,加黄芩。热甚及天令暄热,加石膏。有痰,加竹沥、
姜汁或南星。便秘,加桃仁。小便秘涩,加牛膝。如常肿者,专主乎湿热。肥人,加痰药。
健步丸
苍术 当归尾(各一两) 生地黄 陈皮 芍药(各一两半) 川牛膝(五钱) 大腹子(三钱) 茱萸 条芩(各
五钱) 桂心(二钱)
上为细末,汤浸蒸饼为丸,如梧桐子大,每服一百丸,白术、木通汤送下,食前服。
加味四物汤 治香港脚冲心。
本方加炒黄柏,煎服。更于涌泉穴,用附子末津调捏作饼子贴穴上,以艾炷多灸,以泄引其热下行。
苍术防己丸 治食积流注。
苍术(米泔浸炒) 防己 黄柏(酒炒) 南星(炮裂) 川芎 白芷 犀角 槟榔(各等分)
血虚,加川牛膝、龟板。
上为细末,酒糊为丸,如梧桐子大,每服七、八十丸,白汤下。
转筋,属血热,四物汤加酒芩、红花,煎服。有筋动于足大指,上至大腿近腰结了,此奉养浓,因风寒而作,又当
加苍术、南星。
(以上丹溪方法凡七条)
羌活导滞汤(东垣) 治香港脚初发,一身尽痛,或肢节肿痛,便溺阻膈。先以此药导之,后用当归拈痛汤以撤
其邪。
羌活 独活(各一钱二分) 防己 当归尾(各七分) 大黄(二钱四分) 枳实(五分)
上细切,作一服,水一盏半,煎至一盏,去渣空心温服。
当归拈痛汤(东垣) 治湿热香港脚为病,肢节烦疼,肩背沉重,胸胁不利,兼遍身疼痛,下注足胫肿痛,脚膝
生疮赤肿,及里外生疮,脓水不绝,或庠或痛,并宜服之。
羌活(一钱) 人参 苦参 升麻 葛根 苍术(各四分) 甘草(炙) 黄芩(酒炒) 茵 (酒洗,各一钱) 防
风当归身(酒洗) 知母(去毛,酒制) 泽泻 猪苓(去皮) 白术(各五分)
上细切,作一服,水二盏,煎至一盏,去渣空心温服,临卧再进一服。
开结导饮丸(东垣) 治香港脚,饮食不消,心下痞闷。
白术 橘红 泽泻 神曲(炒) 麦芽面(炒) 半夏(泡七次,各一两) 枳实(麸炒) 巴豆霜(各二钱半) 青
皮干生姜(各五钱) 茯苓(一两)
上为细末,汤浸蒸饼为丸,如梧桐子大,每服五十丸、或七、八十丸,温水下。
麻黄左经汤(三因) 治风寒湿流注足太阳经,腰脚挛痹,关节重痛,增寒壮热,无汗恶寒,或自汗恶风,头
痛脚软等证,并皆治之。
麻黄 干葛 细辛 白术 茯苓 防己 肉桂 羌活(各五分) 甘草 防风(去芦,各二分半)
上细切,作一服,加生姜三片,大枣一枚,水煎服。
半夏左经汤 治足少阳经为风寒湿流注,发热,腰胁疼痛,头目眩晕,呕吐不食,热闷烦心,腿髀缓纵,不能
行步。
半夏 干葛 细辛 白术 麦门冬 茯苓 肉挂 防风 干姜 黄芩(各五分) 小草 甘草 柴胡(各三分)
上细切,作一服,加生姜三片,大枣一枚,水一盏半,煎至一盏,温服。如热闷,加竹沥。喘急,加杏仁、桑白皮。
六物附子汤(三因) 治四气流注于足太阴经,骨节烦疼,四肢拘急,自汗短气,小便不利,手足或肘浮肿。
附子(炮) 肉桂 防己(各一钱) 甘草(炙,五分) 白术 茯苓(各七分半)
上细切,作一服,加生姜三片,水一盏半,煎至一盏,温服。
换腿丸(局方) 治足三阴经为四气所乘,发为挛痹缓纵,上攻胸胁肩背,下注脚膝疼痛,足心发热,行步艰
难。
薏苡仁(炒) 南星(炮裂) 石楠叶 石斛 槟榔 萆 川牛膝(酒洗) 羌活 防风 木瓜(各四两) 黄
当归尾 天麻 续断(各一两)
上为细末,酒糊为丸,如梧桐子大,每服五十丸,盐汤下。
五积散(局方) 治寒湿流注经络,脚膝肿满疼痛等证。(方见腰痛门。)
导水丸 治香港脚跗肿疼痛,或发热恶寒,湿热大盛者。
大黄 黄芩(各二两) 黑丑(取头末) 滑石(各四两)
上为细末,滴水为丸,如梧桐子大,每服四、五十丸,温水送下,以利为度。
除湿丹 治诸湿病,腰膝肿痛,足胫浮肿,筋脉劲急,津液凝涩,便溺不利等证。
槟榔 甘遂(面包水煮) 葳灵仙(去芦) 赤芍药 泽泻 葶苈子(各二两,酒浸炒) 乳香 没药(各一两) 黑
丑(五钱) 大戟(炒,三两) 陈皮(四两)
上为细末,面糊为丸,如梧桐子大,每服五十丸,温水下,以利为度。
三花神 丸(河间) 治湿热流注,足膝浮肿,肢节烦疼,行步重坠等证。(方见痰饮门。)
(祖传方)
杉木节饮 治香港脚发作,恶寒发热,两足肿大,心烦体痛垂死者。
杉木节(四两) 槟榔(七个) 大腹皮(酒洗,一两) 青橘叶(四十九片)
上细切,作一服,用顺流水三升,煎至一升,分作三服,一日服尽。如大便通利黄水,其病除根;未愈,过数日再
煎一剂服之,病根去为度。外以杉木、橘叶不拘多少,煎汤洗之神效。
胜湿饼子 治远年香港脚,足胫肿如瓜瓠者。
黑丑(一两,取头末五钱) 白丑(一两,取头末五钱) 甘遂(连珠者,五钱)
上三味再同研极细,外用荞麦面一两半,连药末和匀,水调捏为饼子,如折三钱大,放饭上蒸熟,每服一饼,空心
嚼,茶清送下,以利为度。未利,又服一饼。忌甘草、菘菜、生冷、油腻、鱼腥等物。
论
《黄帝内经》说:各种湿邪导致的肿胀和腹部胀满,都归属于脾土。又说:被湿邪所伤,身体下部首先受到侵害。因为脾主司四肢,足部位于身体下方且容易受湿邪侵袭,湿气郁结化热,湿热相互搏结,疾病便发作了。因此,病症往往先从气冲穴处的隐核疼痛开始,进而出现双小腿红肿,或者伴有恶寒发热,症状类似伤寒,还有筋脉拘挛牵引作痛,这些都是该病的征候。有时过十天或半个月,病情再次发作如前,逐渐发展到足部筋脉肿大像瓜瓠一样的情况,这种情况有很多。东南地区地势低洼潮湿,这种病比比皆是;西北地区地势高燥,很少见到。古代方书将此病称为“缓风”,从宋代、元代以来被称为“香港脚”。探究其病因,不止一个方面,有因外感邪气而得的,有因内伤而致的,虽然感受的邪气有内外之别,但归结为湿热为患则是一样的。所以《素问·异法方宜论》说:北方地区,地势高峻多山陵居住,风寒冰冽。当地习俗饮用乳酪并食用肉类,都以喝得多、喝得快为能事。经书说:因此大量饮水会导致气机上逆。乳酪和醇酒都是湿热之物,属于饮品类,加上生活供养过于丰厚,又滋生了湿气,水性向下流动,气机不能升发,所以湿气下注于小腿,积久导致肿胀疼痛,这是饮食下行所致。东南地势低洼,湿气弥漫在山泽之间,行走、踩踏、坐卧,无处不有。如果禀赋强壮、气机实盛的人,湿邪不能侵害;如果是气虚血少的人,或者遇到房劳过度,以及负重远行,冒犯雨雪,寒湿乘虚侵袭足部,从而形成此证,这是外感寒湿所致。大体上病因虽有内外之分,但治疗方法没有表里之异。所以治疗时,宣通运用苍术、白术之类来治湿,知母、黄柏、黄芩之类来清热,当归、芍药、生地黄之类来调血,木瓜、槟榔之类来行气,羌活、独活来利关节并散风湿,兼用木通、防己、川牛膝之类引药下行及消肿去湿,作为此证的大法,不过如此。李东垣说:湿邪淫胜,用苦温药治疗,用苦辛药发散它,以透关节胜湿为佐助,用苦寒药泄热。流湿清热为臣药,所以创立当归拈痛汤来治疗,效果迅速如影随形。《灵枢·九针十二原》说:有道而来,必有道以去。治疗适宜多用针灸为佳,以引导湿热之气外出。学者应当详细研究。
脉法
脉象弦的是风邪,濡弱的是湿邪,洪数的是热邪,迟涩的是寒邪,微滑的是虚证,牢坚的是实证,结脉是因为气滞,散脉是因为忧思,紧脉是因为愤怒,细脉是因为悲伤。
方法
朱丹溪说:香港脚由湿邪引起且病位在下,必须提起湿邪,在下部的药物要随气血变化使用。如果邪气入心,则出现神志恍惚、谬误妄言,呕吐,无法进食,睡眠不安,左寸脉忽大忽小或时有时无的,预后不良致死。如果邪气入肾,则腰脚肿胀,小便不通,呻吟,眼睛和前额都发黑,气冲胸中而喘息,左尺脉绝的,预后不良致死。
紫苏、黄柏(用盐和酒拌炒)、芍药、木瓜、泽泻(去毛)、木通(去皮)、防己、槟榔、苍术(米泔水浸泡)、枳壳(麸皮炒至黄色)、甘草(炙烤)、香附(童便浸泡后炒制)、羌活(以上各等分)
黄柏(酒炒)、苍术(盐水炒)、白术、防己(各七分)、生地黄、槟榔、川芎(各五分)、犀角屑、甘草节、木通、黄连(各三分)
将上述药材切碎,作为一服药量,用水一盏半,煎至一盏,去渣滓,饭前温服。有热的,加黄芩。热甚及天气炎热时,加石膏。有痰的,加竹沥、姜汁或天南星。便秘的,加桃仁。小便短赤涩痛的,加牛膝。如果是普通肿胀,主要在于湿热。肥胖的人,加化痰药。
苍术、当归尾(各一两)、生地黄、陈皮、芍药(各一两半)、川牛膝(五钱)、大腹子(三钱)、吴茱萸、黄芩(各五钱)、桂心(二钱)
将上述药材研为细末,用汤浸蒸饼做成丸药,如梧桐子大小,每次服用一百丸,用白术、木通汤送下,饭前服用。
在本方基础上加炒黄柏,煎服。另外在涌泉穴,用附子末调和唾液捏成饼状贴在穴位上,用艾炷多灸,以泄热并引导热气下行。
苍术(米泔水浸炒)、防己、黄柏(酒炒)、天南星(炮裂)、川芎、白芷、犀角、槟榔(各等分)
将上述药材研为细末,用酒糊做成丸药,如梧桐子大小,每次服用七、八十丸,用白开水送下。
转筋,属于血热,用四物汤加酒炒黄芩、红花,煎服。如果有筋脉跳动在大脚趾,向上延伸至大腿近腰部结聚,这是由于营养过剩,因风寒而发作,又当加苍术、天南星。
(以上丹溪的方法共七条)
羌活导滞汤(李东垣) 治疗香港脚初发,全身疼痛,或者肢节肿痛,大小便不通畅。先用此药疏导,后用当归拈痛汤祛除邪气。
羌活、独活(各一钱二分)、防己、当归尾(各七分)、大黄(二钱四分)、枳实(五分)
将上述药材切碎,作为一服药量,用水一盏半,煎至一盏,去渣滓,空腹温服。
当归拈痛汤(李东垣) 治疗湿热香港脚致病,肢节烦疼,肩背沉重,胸胁不利,兼遍身疼痛,湿热下注足胫肿痛,脚膝生疮赤肿,以及内外生疮,脓水不绝,或者痒或者痛,都适宜服用。
羌活(一钱)、人参、苦参、升麻、葛根、苍术(各四分)、甘草(炙)、黄芩(酒炒)、茵陈(酒洗,各一钱)、防风、当归身(酒洗)、知母(去毛,酒制)、泽泻、猪苓(去皮)、白术(各五分)
将上述药材切碎,作为一服药量,用水二盏,煎至一盏,去渣滓,空腹温服,临睡前再服一次。
白术、橘红、泽泻、神曲(炒)、麦芽面(炒)、半夏(泡七次,各一两)、枳实(麸炒)、巴豆霜(各二钱半)、青皮、干生姜(各五钱)、茯苓(一两)
将上述药材研为细末,用汤浸蒸饼做成丸药,如梧桐子大小,每次服用五十丸、或七、八十丸,温水送下。
麻黄左经汤(《三因极一病证方论》) 治疗风寒湿邪流注足太阳经,腰脚拘挛麻痹,关节重痛,怕冷高热,无汗恶寒,或者自汗恶风,头痛脚软等症状,都治疗。
麻黄、干葛、细辛、白术、茯苓、防己、肉桂、羌活(各五分)、甘草、防风(去芦,各二分半)
将上述药材切碎,作为一服药量,加生姜三片,大枣一枚,用水煎服。
半夏左经汤 治疗足少阳经受风寒湿邪流注,发热,腰胁疼痛,头目眩晕,呕吐不食,热闷烦心,腿髀松弛无力,不能行走。
半夏、干葛、细辛、白术、麦门冬、茯苓、肉桂、防风、干姜、黄芩(各五分)、小草、甘草、柴胡(各三分)
将上述药材切碎,作为一服药量,加生姜三片,大枣一枚,用水一盏半,煎至一盏,温服。如果热闷,加竹沥。喘急,加杏仁、桑白皮。
六物附子汤(《三因极一病证方论》) 治疗四气流注于足太阴经,骨节烦疼,四肢拘急,自汗短气,小便不利,手足或肘部浮肿。
附子(炮制)、肉桂、防己(各一钱)、甘草(炙,五分)、白术、茯苓(各七分半)
将上述药材切碎,作为一服药量,加生姜三片,用水一盏半,煎至一盏,温服。
换腿丸(《太平惠民和剂局方》) 治疗足三阴经受四气侵袭,发作拘挛麻痹松弛无力,上攻胸胁肩背,下注脚膝疼痛,足心发热,行走艰难。
薏苡仁(炒)、天南星(炮裂)、石楠叶、石斛、槟榔、萆薢、川牛膝(酒洗)、羌活、防风、木瓜(各四两)、黄芪、当归尾、天麻、续断(各一两)
将上述药材研为细末,用酒糊做成丸药,如梧桐子大小,每次服用五十丸,盐汤送下。
五积散(《太平惠民和剂局方》) 治疗寒湿流注经络,脚膝肿满疼痛等症状。(方剂见腰痛门。)
将上述药材研为细末,滴水做成丸药,如梧桐子大小,每次服用四、五十丸,温水送下,以利下为度。
除湿丹 治疗各种湿病,腰膝肿痛,足胫浮肿,筋脉劲急,津液凝涩,大小便不利等症状。
槟榔、甘遂(面包水煮)、威灵仙(去芦)、赤芍药、泽泻、葶苈子(各二两,酒浸炒)、乳香、没药(各一两)、黑丑(五钱)、大戟(炒,三两)、陈皮(四两)
将上述药材研为细末,面糊做成丸药,如梧桐子大小,每次服用五十丸,温水送下,以利下为度。
三花神丸(刘河间) 治疗湿热流注,足膝浮肿,肢节烦疼,行走沉重坠胀等症状。(方剂见痰饮门。)
(祖传方)
杉木节饮 治疗香港脚发作,恶寒发热,两足肿大,心烦体痛垂死者。
杉木节(四两)、槟榔(七个)、大腹皮(酒洗,一两)、青橘叶(四十九片)
将上述药材切碎,作为一服药量,用顺流水三升,煎至一升,分作三次服用,一天服完。如果大便通畅排出黄水,病根去除;未痊愈,过几天再煎一剂服用,直到病根去除为止。外用杉木、橘叶不拘多少,煎汤清洗,效果神奇。
黑丑(一两,取头末五钱)、白丑(一两,取头末五钱)、甘遂(连珠者,五钱)
将上述三味药再次研磨极细,外用荞麦面一两半,连同药末混合均匀,用水调捏成饼子,如折三钱大,放在饭上蒸熟,每次服用一饼,空腹嚼碎,茶清送下,以利下为度。未利下,再服一饼。忌食甘草、白菜、生冷、油腻、鱼腥等物。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All dampness-induced swelling and fullness belong to Spleen Earth." It also says: "When injured by dampness, the lower part of the body is affected first." This is because the Spleen governs the four limbs; the feet are located at the lower part and are prone to dampness invasion. When dampness stagnates and transforms into heat, and damp-heat interact and contend, the disease arises. Therefore, the condition often begins with pain in the hidden nodules at the Qichong (ST30) acupoint, followed by redness and swelling of both calves, or accompanied by aversion to cold and fever, resembling Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang meridian), along with tendon spasms and pulling pain. These are its manifestations. Sometimes, after ten days or half a month, it recurs as before, gradually progressing to significant swelling of the foot tendons resembling a gourd. This is common. In the low-lying and damp regions of the Southeast, this disease is ubiquitous; in the high and dry regions of the Northwest, it is rare. Ancient formularies called this condition "Huan Feng" (Slow Wind); since the Song and Yuan dynasties, it has been referred to as "Hong Kong Jiao" (Gouty Arthritis/Chronic Lower Limb Edema). Investigating its etiology, there is more than one cause: some arise from external pathogens, others from internal injury. Although the sources of pathogenic factors differ between external and internal, they all result in damp-heat pathology. Thus, the *Ling Shu · Yi Fa Fang Yi Lun* (Treatise on Different Therapeutic Methods for Different Regions) states: "In the Northern region, the terrain is high with hills and mountains. The people drink milk and cheese and eat meat, valuing large quantities consumed quickly. The classics say: 'Excessive drinking leads to rebellious Qi.' Milk, cheese, and strong wine are damp-heat substances. Consuming them, combined with excessive nourishment, generates more dampness. Water nature flows downward, and Qi fails to ascend, so dampness sinks to the calves, accumulating over time to cause swelling and pain. This is due to dietary fluids flowing downward." In the Southeast, the terrain is low, and dampness fills the mountains and marshes. Walking, sitting, and lying down, one is exposed everywhere. If one has robust constitution and sufficient Qi, dampness cannot invade; but if one is deficient in Qi and blood, or experiences sexual exhaustion, carries heavy loads over long distances, or exposes oneself to rain and snow, cold-dampness invades the feet when defenses are weak, forming this syndrome. This is caused by external cold-damp invasion. Generally, although etiologies differ internally and externally, treatment methods do not distinguish strictly between exterior and interior. Therefore, in treatment, one should use aromatic damp-resolving herbs like Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to treat dampness; Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), and Huang Qin (Scutellariae Radix) to clear heat; Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix), and Sheng Di Huang (Rehmanniae Radix) to regulate blood; Mu Gua (Chaenomelis Fructus) and Bing Lang (Arecae Semen) to move Qi; Qiang Huo (Notopterygii Rhizoma et Radix) and Du Huo (Angelicae Pubescentis Radix) to benefit joints and dispel wind-dampness; and jointly use Mu Tong (Akebiae Caulis), Fang Ji (Stephaniae Tetrandrae Radix), and Chuan Niu Xi (Cyathulae Radix) to guide medicines downward, reduce swelling, and drain dampness. This is the general principle for treating this condition. Li Dongyuan said: "When dampness prevails excessively, treat with bitter-warm herbs, disperse with bitter-acrid herbs, assist with herbs that penetrate joints to overcome dampness, and drain with bitter-cold herbs. Draining dampness and clearing heat serves as the minister herb. Thus, Dang Gui Jian Tong Tang (Dang Gui Decoction for Relieving Pain) was established to treat it, with effects swift as shadow and echo." The *Zhen Jing* (Classic of Acupuncture) states: "What comes by a certain way must leave by a certain way." Treatment is best suited with acupuncture and moxibustion to guide damp-heat Qi outwards. Students should study this in detail.
Pulse Diagnosis
A wiry pulse indicates Wind; a soggy and weak pulse indicates Dampness; a flooding and rapid pulse indicates Heat; a slow and choppy pulse indicates Cold; a fine and slippery pulse indicates Deficiency; a firm and hard pulse indicates Excess; a knotted pulse is due to Qi stagnation; a scattered pulse is due to worry; a tight pulse is due to anger; a thin pulse is due to sorrow.
Methods
Zhu Danxi said: "Hong Kong Jiao stems from dampness and affects the lower body. One must lift the dampness, and herbs acting on the lower body should be used according to Qi and Blood dynamics. If the pathogen enters the Heart, there will be mental confusion, delirium, vomiting, inability to eat, restlessness in sleep. If the left Cun pulse fluctuates between large and small or appears and disappears intermittently, the prognosis is fatal. If the pathogen enters the Kidney, there will be swelling of the waist and feet, urinary obstruction, groaning, blackening of the eyes and forehead, Qi rushing to the chest causing panting. If the left Chi pulse vanishes, the prognosis is fatal."
Formula for Treating Damp-Heat Hong Kong Jiao
Zi Su (Perillae Folium), Huang Bo (Phellodendri Cortex - stir-fried with salt and wine), Shao Yao (Paeoniae Radix), Mu Gua (Chaenomelis Fructus), Ze Xie (Alismatis Rhizoma - remove hairs), Mu Tong (Akebiae Caulis - remove skin), Fang Ji (Stephaniae Tetrandrae Radix), Bing Lang (Arecae Semen), Cang Zhu (Atractylodis Rhizoma - soak in rice wash water), Zhi Ke (Aurantii Fructus - stir-fried with bran until yellow), Gan Cao (Glycyrrhizae Radix et Rhizoma - honey-fried), Xiang Fu (Cyperii Rhizoma - soak in child's urine and stir-fry), Qiang Huo (Notopterygii Rhizoma et Radix) [All equal parts].
Add Mu Xiang (Vladimiriae Radix) for pain; add Da Fu Pi (Arecae Pericarpium) for severe swelling; add Huang Lian (Coptidis Rhizoma) and Da Huang (Rhei Radix et Rhizoma) for fever.
Cut finely, decoct in water, and take orally. Stop taking when pain subsides and swelling recedes.
Fang Ji Yin (Stephania Decoction)
Huang Bo (Phellodendri Cortex - wine-fried), Cang Zhu (Atractylodis Rhizoma - salt-water fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix) [Each 7 fen], Sheng Di Huang (Rehmanniae Radix), Bing Lang (Arecae Semen), Chuan Xiong (Ligusticum Chuanxiong Rhizoma) [Each 5 fen], Xi Jiao (Rhinocerotis Cornu - shaved pieces), Gan Cao Jie (Glycyrrhizae Radix et Rhizoma - knotted ends), Mu Tong (Akebiae Caulis), Huang Lian (Coptidis Rhizoma) [Each 3 fen].
Cut finely, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup, remove dregs, and take warm before meals. If there is heat, add Huang Qin (Scutellariae Radix). If heat is severe or during hot weather, add Shi Gao (Gypsum Fibrosum). If there is phlegm, add Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Rhizoma Recens Succus), or Nan Xing (Arisaematis Rhizoma). For constipation, add Tao Ren (Persicae Semen). For scanty, painful urination, add Niu Xi (Achyranthis Bidentatae Radix). For ordinary swelling, focus primarily on damp-heat. For obese individuals, add phlegm-resolving herbs.
Jian Bu Wan (Strengthen Legs Pill)
Cang Zhu (Atractylodis Rhizoma), Dang Gui Wei (Angelicae Sinensis Radix - tail) [Each 1 liang], Sheng Di Huang (Rehmanniae Radix), Chen Pi (Citri Reticulatae Pericarpium), Shao Yao (Paeoniae Radix) [Each 1.5 liang], Chuan Niu Xi (Cyathulae Radix) [5 qian], Da Fu Zi (Arecae Pericarpium) [3 qian], Yu Zhu (Corni Fructus), Tiao Qin (Scutellariae Radix) [Each 5 qian], Gui Xin (Cinnamomi Cortex - heartwood) [2 qian].
Grind into fine powder. Soak steamed bread dough in water to form pills, size of Sophora seeds. Take 100 pills per dose, washed down with decoction of Bai Zhu and Mu Tong, before meals.
Modified Si Wu Tang (Four Substances Decoction) for Treating Hong Kong Jiao Rushing to the Heart.
Add stir-fried Huang Bo to the base formula, decoct, and take. Additionally, apply a paste made of Fu Zi (Aconiti Lateralis Radix Praeparata) powder mixed with saliva to Yongquan (KI1) acupoint. Moxibustion with multiple cones should be applied to vent heat and guide it downwards.
Cang Zhu Fang Ji Wan (Atractylodes and Stephania Pill) for Treating Food Stagnation Flowing Downward.
Cang Zhu (Atractylodis Rhizoma - soaked in rice wash and stir-fried), Fang Ji (Stephaniae Tetrandrae Radix), Huang Bo (Phellodendri Cortex - wine-fried), Nan Xing (Arisaematis Rhizoma - processed until cracked), Chuan Xiong (Ligusticum Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Xi Jiao (Rhinocerotis Cornu), Bing Lang (Arecae Semen) [All equal parts].
For blood deficiency, add Chuan Niu Xi (Cyathulae Radix) and Gui Ban (Testudinis Carapax et Plastrum).
Grind into fine powder. Form pills with wine paste, size of Sophora seeds. Take 70-80 pills per dose, washed down with plain warm water.
Tendon spasm belongs to Blood Heat. Use Si Wu Tang (Four Substances Decoction) added with Jiu Qin (Scutellariae Radix - wine-fried) and Hong Hua (Carthami Flos), decoct, and take. If tendons twitch in the big toe and extend up to the thigh near the waist, this is due to excessive nourishment combined with Wind-Cold. Add Cang Zhu and Nan Xing.
(Above are seven methods from Danxi.)
Qiang Huo Dao Zhi Tang (Notopterygi Decoction for Guiding Out Stagnation) by Li Dongyuan. For early stage Hong Kong Jiao, whole-body pain, or joint swelling and pain, with obstructed urination and defecation. Use this medicine first to guide out stagnation, then use Dang Gui Jian Tong Tang to eliminate pathogens.
Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix) [Each 1.2 qian], Fang Ji (Stephaniae Tetrandrae Radix), Dang Gui Wei (Angelicae Sinensis Radix - tail) [Each 7 fen], Da Huang (Rhei Radix et Rhizoma) [2.4 qian], Zhi Shi (Aurantii Fructus Immaturus) [5 fen].
Cut finely, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup, remove dregs, and take warm on an empty stomach.
Dang Gui Jian Tong Tang (Dang Gui Decoction for Relieving Pain) by Li Dongyuan. For diseases caused by damp-heat Hong Kong Jiao, vexing pain in limbs and joints, heaviness in shoulders and back, oppression in chest and hypochondrium, generalized body pain, damp-heat sinking to swollen and painful calves, sores on feet and knees with redness and swelling, internal and external sores with continuous pus and fluid, itching or pain. All are suitable for this prescription.
Qiang Huo (Notopterygii Rhizoma et Radix) [1 qian], Ren Shen (Ginseng Radix), Ku Shen (Sophorae Flavescentis Radix), Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Cang Zhu (Atractylodis Rhizoma) [Each 4 fen], Gan Cao (Glycyrrhizae Radix et Rhizoma - honey-fried), Huang Qin (Scutellariae Radix - wine-fried), Yin Chen (Artemisiae Scopariae Herba - wine-rinsed) [Each 1 qian], Fang Feng (Saposhnikoviae Radix), Dang Gui Shen (Angelicae Sinensis Radix - body, wine-rinsed), Zhi Mu (Anemarrhenae Rhizoma - remove hairs, wine-processed), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [Each 5 fen].
Cut finely, prepare as one dose. Add 2 cups of water, decoct to 1 cup, remove dregs, and take warm on an empty stomach. Take another dose before bed.
Kai Jie Dao Yin Wan (Unbind Knots and Guide Fluids Pill) by Li Dongyuan. For Hong Kong Jiao with indigestion and epigastric fullness/oppression.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Ze Xie (Alismatis Rhizoma), Shen Qu (Massa Medicata Fermentata - stir-fried), Mai Ya Mian (Hordei Fructus Germinatus Powder - stir-fried), Ban Xia (Pinelliae Rhizoma - soaked seven times) [Each 1 liang], Zhi Shi (Aurantii Fructus Immaturus - stir-fried with bran), Ba Dou Shuang (Crotonis Fructus Frost) [Each 2.5 qian], Qing Pi (Citri Reticulatae Pericarpium Viride), Gan Sheng Jiang (Zingiberis Rhizoma Recens - dried) [Each 5 qian], Fu Ling (Poria) [1 liang].
Grind into fine powder. Soak steamed bread dough in water to form pills, size of Sophora seeds. Take 50 or 70-80 pills per dose, washed down with warm water.
Ma Huang Zuo Jing Tang (Ephedra Left Meridian Decoction) from *San Yin Fang*. For Wind-Cold-Dampness flowing into the Foot-Taiyang Meridian, causing leg and foot spasms and numbness, heavy and painful joints, increased chills and high fever, absence of sweating and aversion to cold, or spontaneous sweating and aversion to wind, headache, and weak legs. Treats all these syndromes.
Ma Huang (Ephedrae Herba), Gan Ge (Puerariae Lobatae Radix), Xi Xin (Asari Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Fang Ji (Stephaniae Tetrandrae Radix), Rou Gui (Cinnamomi Cortex), Qiang Huo (Notopterygii Rhizoma et Radix) [Each 5 fen], Gan Cao (Glycyrrhizae Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix - remove rhizome stump) [Each 2.5 fen].
Cut finely, prepare as one dose. Add 3 slices of Sheng Jiang (Zingiberis Rhizoma Recens) and 1 Da Zao (Jujubae Fructus), decoct in water, and take.
Ban Xia Zuo Jing Tang (Pinellia Left Meridian Decoction). For Wind-Cold-Dampness flowing into the Foot-Shaoyang Meridian, causing fever, waist and hypochondriac pain, dizziness and vertigo, vomiting and anorexia, heat oppression and irritability, flaccidity of thighs and legs, inability to walk.
Ban Xia (Pinelliae Rhizoma), Gan Ge (Puerariae Lobatae Radix), Xi Xin (Asari Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mai Men Dong (Ophiopogonis Radix), Fu Ling (Poria), Rou Gui (Cinnamomi Cortex), Fang Feng (Saposhnikoviae Radix), Gan Jiang (Zingiberis Rhizoma), Huang Qin (Scutellariae Radix) [Each 5 fen], Xiao Cao (Polygoni Avicularis Herba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chai Hu (Bupleuri Radix) [Each 3 fen].
Cut finely, prepare as one dose. Add 3 slices of Sheng Jiang (Zingiberis Rhizoma Recens) and 1 Da Zao (Jujubae Fructus), add 1.5 cups of water, decoct to 1 cup, and take warm. If heat oppression, add Zhu Li (Bambusae Succus). If panting and urgency, add Xing Ren (Armeniacae Semen Amarum) and Sang Bai Pi (Mori Cortex).
Liu Wu Fu Zi Tang (Six-Ingredient Aconite Decoction) from *San Yin Fang*. For Four Qi flowing into the Foot-Taiyin Meridian, causing vexing bone and joint pain, limb spasms and stiffness, spontaneous sweating, shortness of breath, difficult urination, or edema of hands, feet, or elbows.
Fu Zi (Aconiti Lateralis Radix Praeparata - processed), Rou Gui (Cinnamomi Cortex), Fang Ji (Stephaniae Tetrandrae Radix) [Each 1 qian], Gan Cao (Glycyrrhizae Radix et Rhizoma - honey-fried) [5 fen], Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria) [Each 7.5 fen].
Cut finely, prepare as one dose. Add 3 slices of Sheng Jiang (Zingiberis Rhizoma Recens), add 1.5 cups of water, decoct to 1 cup, and take warm.
Huan Tui Wan (Leg-Swapping Pill) from *Ju Fang*. For Foot-Yin meridians invaded by Four Qi, causing spasms, numbness, flaccidity, upward attack to chest, hypochondrium, shoulders, and back, downward sinking to painful feet and knees, heat in soles of feet, and difficulty walking.
Yi Yi Ren (Coicis Semen - stir-fried), Nan Xing (Arisaematis Rhizoma - processed until cracked), Shi Nan Ye (Foliium Nandinae), Shi Hu (Dendrobii Caulis), Bing Lang (Arecae Semen), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Chuan Niu Xi (Cyathulae Radix - wine-rinsed), Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Mu Gua (Chaenomelis Fructus) [Each 4 liang], Huang Qi (Astragali Radix), Dang Gui Wei (Angelicae Sinensis Radix - tail), Tian Ma (Gastrodiae Rhizoma), Xu Duan (Dipsaci Radix) [Each 1 liang].
Grind into fine powder. Form pills with wine paste, size of Sophora seeds. Take 50 pills per dose, washed down with salt water.
Wu Ji San (Five Accumulations Powder) from *Ju Fang*. For Cold-Dampness flowing into collaterals and channels, causing swelling, fullness, and pain in feet and knees. (See Formula in Waist Pain Section.)
Dao Shui Wan (Water-Guiding Pill). For Hong Kong Jiao with dorsal foot swelling and pain, or fever and aversion to cold, where damp-heat is abundant.
Da Huang (Rhei Radix et Rhizoma), Huang Qin (Scutellariae Radix) [Each 2 liang], Hei Chou (Bruxellae Semen Caput Finest Powder), Hua Shi (Talcum) [Each 4 liang].
Grind into fine powder. Form pills with drops of water, size of Sophora seeds. Take 40-50 pills per dose, washed down with warm water. Stop when bowel movement occurs.
Chu Shi Dan (Dampness-Removing Elixir). For various dampness diseases, including waist and knee swelling and pain, calf edema, stiff and tense sinews, coagulated body fluids, and difficult urination and defecation.
Bing Lang (Arecae Semen), Gan Sui (Kansui Radix - boiled in flour wrapper), Wei Ling Xian (Clematidis Radix et Rhizoma), Chi Shao Yao (Paeoniae Radix Rubra), Ze Xie (Alismatis Rhizoma), Ting Li Zi (Lepidii Fructus) [Each 2 liang, soaked in wine and stir-fried], Ru Xiang (Olibanum), Mo Yao (Myrrha), Hei Chou (Bruxellae Semen Caput Finest Powder) [Each 1 liang], Da Ji (Euphorbiae Pekinensis Radix - stir-fried) [3 liang], Chen Pi (Citri Reticulatae Pericarpium) [4 liang].
Grind into fine powder. Form pills with flour paste, size of Sophora seeds. Take 50 pills per dose, washed down with warm water. Stop when bowel movement occurs.
San Hua Shen Wan (Three-Flower Divine Pill) by Liu Hejian. For damp-heat flowing downward, causing foot and knee edema, vexing pain in joints, and heavy sensation while walking. (See Formula in Phlegm-Fluids Section.)
(Ancestral Formula)
Shan Mu Jie Yin (Chinese Fir Node Decoction). For acute attacks of Hong Kong Jiao with chills and fever, massive swelling of both feet, irritability, body pain, and critical condition.
Shan Mu Jie (Taxilli Cuspidati Ramulus) [4 liang], Bing Lang (Arecae Semen) [7 pieces], Da Fu Pi (Arecae Pericarpium - wine-rinsed) [1 liang], Qing Ju Ye (Citri Reticulatae Folium) [49 leaves].
Cut finely, prepare as one dose. Use 3 sheng of smooth-flowing water, decoct to 1 sheng. Divide into three doses, consume within one day. If stool becomes loose with yellow fluid, the root cause is eliminated. If not cured, decoct another dose after a few days until the root cause is removed. Externally, boil Shan Mu (Taxillus) and Ju Ye (Citri Reticulatae Folium) in any amount to make a decoction for washing, which is miraculous.
Sheng Shi Bing Zi (Dampness-Overcoming Cake). For chronic Hong Kong Jiao with calves swollen like gourds.
Hei Chou (Bruxellae Semen Caput Finest Powder) [1 liang, take 5 qian of head powder], Bai Chou (Bruxellae Semen Albus Caput Finest Powder) [1 liang, take 5 qian of head powder], Gan Sui (Kansui Radix - nodular type) [5 qian].
Grind the above three ingredients extremely fine. Mix with 1.5 liang of Buckwheat Flour (Fagopyri Dibotryis Rhizoma). Knead into cakes using water, size of a coin worth three cash. Steam on rice until cooked. Take one cake per dose, chew thoroughly on an empty stomach, wash down with clear tea. Stop when bowel movement occurs. If no bowel movement, take another cake. Avoid Gan Cao (Glycyrrhizae Radix et Rhizoma), Song Cai (Brassicae Pekinensis Folium), raw/cold foods, greasy foods, and fishy smells.